CN102368960A - 包括关节接头的手术缝合器械 - Google Patents

包括关节接头的手术缝合器械 Download PDF

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CN102368960A
CN102368960A CN2010800146605A CN201080014660A CN102368960A CN 102368960 A CN102368960 A CN 102368960A CN 2010800146605 A CN2010800146605 A CN 2010800146605A CN 201080014660 A CN201080014660 A CN 201080014660A CN 102368960 A CN102368960 A CN 102368960A
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end effector
electromagnet
magnetics
joint
joint motions
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CN102368960B (zh
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C·J·沙伊贝
G·S·贾沃克
S·G·霍尔
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Ethicon Endo Surgery Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003Steerable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft

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Abstract

本发明提供了一种手术缝合器械,在多个实施例中,所述手术缝合器械可包括多个磁性元件,所述多个磁性元件能够使所述外科器械的端部执行器进行关节运动。所述外科器械可包括至少一个电磁体,所述至少一个电磁体能够被有选择地激活或极化以产生磁场,所述磁场足以促动安装到所述端部执行器的第二磁性元件,例如永久磁体和/或铁芯。在某些实施例中,手术缝合器械可包括多个磁性元件,所述多个磁性元件能够打开和/或关闭所述外科器械的端部执行器。在至少一个实施例中,手术缝合器械可包括多个磁性元件,所述多个磁性元件能够在所述外科器械内推进和/或收回击发杆、切割构件和/或缝钉橇,以便切割和/或缝合定位在所述外科器械的端部执行器内的组织。

Description

包括关节接头的手术缝合器械
背景技术
i.技术领域
本发明整体涉及外科器械,更具体地讲,涉及手术缝合器械。
ii.相关领域的背景技术
手术缝合器械已被用来同时在组织内制备切口并将几排缝钉施加到切口的相对侧。这种器械常常包括一对协同工作的钳口构件,如果意图将所述器械用于内窥镜式或腹腔镜式应用,则所述钳口构件能够穿过套管通道。在各种实施例中,其中一个钳口构件可以接纳具有至少两行横向间隔开的缝钉的钉仓。另一钳口构件可以限定砧座,所述砧座具有与钉仓中的成行的缝钉对齐的缝钉成形凹陷部。该器械还可包括多个楔或缝钉橇,当向远侧驱动时,其穿过钉仓内的开口并与支撑缝钉的驱动器接合,以便使缝钉朝砧座击发。通过在切口每侧上形成几行缝钉的同时切断组织,可以减少流血和简化各种外科手术。然而在某些情况下,形成缝钉并同时切割组织所需的力可能很大。
以前的手术缝合器械包括柄部组件、从柄部组件延伸的细长轴、以及活动安装到细长轴的端部执行器,其中端部执行器可以相对于细长轴进行关节运动。通常,外科医生需要使用双手,以使端部执行器相对于轴进行关节运动,即外科医生往往需要用一只手握住(例如)外科器械的柄部组件,并用另一只手操作使端部执行器进行关节运动的(例如)杠杆。虽然这类外科器械可能在许多情况下适合,但是外科医生可能腾不出手来进行外科手术中的另外的步骤。上述讨论仅仅为了举例说明技术领域内目前存在的一些不足,而不应看作是对权利要求范围的否定。
发明内容
在一个一般方面,外科器械可包括多个磁性元件,所述多个磁性元件能够使外科器械的端部执行器进行关节运动。外科器械可包括至少一个电磁体,所述至少一个电磁体可以被有选择地激活或极化以产生磁场,该磁场足以激发(例如)安装到端部执行器的至少一个第二磁性元件,例如永久磁体和/或铁芯。在各种实施例中,外科器械可包括第一电磁体和第二电磁体,第一电磁体能够产生第一磁场,第一磁场使端部执行器在第一方向上旋转;第二电磁体能够产生第二磁场,第二磁场使端部执行器在第二方向上旋转。在某些实施例中,外科器械可包括至少一个螺线管,所述至少一个螺线管可以能够使外科器械的端部执行器枢转。
在一个一般方面,外科器械可包括电机,所述电机可以能够使外科器械的端部执行器枢转。在某些实施例中,电机可包括绕组,所述绕组可以有选择地通电,以旋转铁芯。在至少一个实施例中,电机可包括至少一个电磁体,所述至少一个电磁体可以能够使安装有至少一个磁性元件的轴旋转。在各种实施例中,外科器械还可包括锁和/或制动器,所述锁和/或制动器可以能够防止或至少抑制外科器械的端部执行器的关节运动。在某些实施例中,锁可包括至少一个螺线管、电机和/或电磁体,这些部件可以能够在锁紧位置和解锁位置之间运动锁紧元件,以使锁紧元件与端部执行器接合和分离。
在一个一般方面,外科器械可包括多个磁性元件,所述多个磁性元件能够打开和关闭外科器械的端部执行器。在某些实施例中,外科器械可包括至少一个电磁体,所述至少一个电磁体可以被有选择地激活或极化以产生磁场,该磁场足以激发(例如)安装到端部执行器的砧座的至少一个第二磁性元件,例如永久磁体和/或铁芯。在另一个一般方面,手术缝合器械可包括多个磁性元件,所述多个磁性元件能够在外科器械内推进和/或收回击发杆、切割构件和/或缝钉橇,以便切割和/或缝合定位在外科器械的端部执行器内的组织。在某些实施例中,切割元件可包括安装在上面的至少一个电磁体,所述至少一个电磁体可以能够产生磁场,该磁场能够与(例如)安装到端部执行器的一个或多个永久磁体相互作用。
本发明内容旨在简要概述本申请的某些实施例。应当理解,本申请不限于本发明内容中所公开的实施例,而是有意涵盖其权利要求书所规定的精神和范围内的修改形式。还应当理解,本发明内容不应被解读或理解为将用来限制权利要求书的范围。
附图说明
通过结合附图参考本发明实施例的以下说明,本发明的上述和其他特征及优点及其获取方法将会变得更加明显,并可更好地理解发明本身,其中:
图1A为手术缝合器械的透视图,该手术缝合器械包括柄部组件、从柄部组件延伸的细长轴,以及从细长轴延伸的能进行关节运动的端部执行器;
图1B为图1的外科手术器械的端部执行器的分解图;
图2为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的透视图,所示出的关节接头移除了一些元件;
图3为图2的端部执行器的剖视图,图中示出了定位在外科器械的细长轴内的螺线管,其中螺线管能够使端部执行器进行关节运动;
图4为图2的端部执行器、关节接头和细长轴的局部透视图,图中所示移除了一些元件;
图5为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的侧剖视图;
图6为图5的外科器械沿图5的线6-6截取的底部剖视图,图中示出了螺线管驱动的关节运动锁;
图7为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的剖视图;
图8为图7的关节接头的细部图,图中示出了能够使端部执行器进行关节运动的电机;
图9为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的剖视图;
图10为图9的端部执行器、关节接头和细长轴的局部透视图,图中示出了与能够使端部执行器进行关节运动的蜗轮可操作地接合的电机;
图11为图9的端部执行器、关节接头和细长轴的另一个局部透视图,图中所示移除了一些元件;
图12为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的局部透视图;
图13为图12的端部执行器、关节接头和细长轴的剖视图,图中示出了能够使端部执行器进行关节运动的电机驱动管;
图14为图12的端部执行器、关节接头和细长轴的另一个局部透视图,图中移除了一些元件,并用虚线示出了其他元件;
图15为图12的关节接头的分解图;
图16为外科器械的透视图,该外科器械具有用于使外科器械的端部执行器进行关节运动的关节运动旋钮和用于旋转端部执行器的旋转钮;
图17为图16的外科器械的柄部的侧剖视图;
图18为图17的柄部的透视剖视图;
图19为图17的柄部的分解图;
图20为根据本发明的至少一个实施例的外科器械的透视图,该外科器械包括关节运动开关和旋转开关;
图21为图20的外科器械的柄部的剖视图;
图22为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的透视图,图中所示移除了一些元件;
图23为示意图,示出了定位在图22的细长轴内的电磁体,该电磁体能够向安装到图22的端部执行器的永久磁体施加磁力;
图24为图22的细长轴的剖视图;
图25为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的透视图,图中移除了一些元件;
图26为图25的端部执行器的剖视图,图中示出了多个电磁体;
图27为连接根据本发明的至少一个实施例的外科器械的端部执行器和细长轴的关节接头的透视图,图中所示移除了一些元件;
图28为图27的关节接头的剖视图,图中示出了一系列永久磁体和电磁体,这些永久磁体和电磁体能够使外科器械的端部执行器进行关节运动;以及另外一系列永久磁体和电磁体,这些永久磁体和电磁体能够将端部执行器相对于外科器械的细长轴锁定就位;
图29为图27的关节接头的拆卸图,图中所示移除了一些元件;
图30为图27的关节接头的分解图;
图31为图27的关节接头的剖视图,图中示出了用于使外科器械的端部执行器进行关节运动的该系列永久磁体和电磁体;
图32为图27的关节接头的剖视图,图中示出了用于将端部执行器锁定就位的该系列永久磁体和电磁体;
图33为根据本发明的至少一个实施例的外科器械的透视图,该外科器械包括柄部组件、细长轴和能相对于细长轴进行关节运动的端部执行器;
图34为连接图33的细长轴和端部执行器的关节接头的剖视图,其中关节接头包括多个圆盘;
图35为图34的关节接头的剖视图,图中示出了处于关节运动构型的关节接头;
图36为图34的关节接头的圆盘的剖面透视图,图中示出了定位在第一组孔内的电磁体和延伸穿过另一组孔的线,该线将电磁体电连接到电源;
图37为图36的圆盘的另一个剖面透视图;
图38为图36的圆盘和与该圆盘相邻定位的第二圆盘的装配图,其中第二圆盘包括定位在第一组孔和另一组孔内的多个永久磁体,所述另一组孔能够允许图36的线延伸穿过其中;
图39为图36的圆盘的分解图;
图40为图34的关节接头的永久磁体和电磁体的电气原理图;
图41为根据本发明的至少一个可供选择的实施例的外科器械的关节接头的局部透视图,图中所示移除了一些元件,并且在剖视图中示出了其他元件;
图42为图41的关节接头的剖视图,图中示出了关节接头的交替的第一和第二圆盘;
图43为以关节运动构型示出的图41的关节接头的剖视图;
图44为图41的关节接头的端视图;
图45为图41的关节接头的另一个剖视图,图中示出了定位在关节接头的圆盘内的电磁体线的伸展和收缩构型;
图46为根据本发明的至少一个实施例的外科器械的端部执行器的剖视图,图中示出了定位在端部执行器的砧座内的多个永久磁体;
图47为图46的砧座的正视图;
图48为图46的端部执行器的切割构件的正视图,该切割构件包括多个电磁体,所述多个电磁体能够与定位在外科器械的端部执行器内的永久磁体配合,并且在端部执行器内推进和/或收回切割构件;
图49为图48的切割构件的透视图;
图50为图46的端部执行器的另一个剖视图;
图51A-51C示出了根据本发明的至少一个实施例的外科器械的细长轴及定位在细长轴内的活动击发杆的远侧部分、中部和近侧部分;
图51A为细长轴和活动击发杆的远侧部分的剖视图,图中示出了定位在细长轴内的一系列电磁体;
图51B为图51A的细长轴和活动击发杆的中部的剖视图,图中示出了安装到击发杆的永久磁体和定位在细长轴内的电磁体;
图51C为图51A的细长轴和活动击发杆的近侧部分的剖视图;
图52为图51A-C的细长轴和活动击发杆的剖视图;
图53为图51A的细长轴和活动击发杆的远侧部分的另一个剖视图,图中示出了处于击发位置的击发杆;
图54为根据本发明的至少一个实施例的外科器械的细长轴的剖视图,图中示出了处于未击发位置的击发杆;
图55为图54的外科器械的剖视图,图中示出了被电磁线圈运动到击发位置的击发杆。
对应参考符号表明贯穿若干视图的对应部分。本文示出的范例(以一种形式)示出本发明的优选实施例,不应将这种范例理解为是以任何方式限制本发明的范围。
具体实施方式
现在将描述一些示例性实施例来提供对本文公开的器械和方法的结构、功能、制造和使用原理的全面理解。这些实施例中的一个或多个实例在附图中示出。本领域的普通技术人员将会理解,本文特别描述和在附图中示出的器械和方法为非限制性的示例性实施例,并且本发明多个实施例的范围仅由权利要求书限定。结合一个示例性实施例示出或描述的特征可以与其他实施例的特征组合。这种修改形式和变型形式旨在包括在本发明的范围内。
下列共同拥有的、同时提交的美国专利申请的公开内容均全文以引用方式并入本文中:
(1)名称为“SURGICAL STAPLING INSTRUMENT”(手术缝合器械)、代理人案卷号为END6570USNP/090046的美国专利申请No.____________;和
(2)名称为“SURGICAL STAPLING INSTRUMENTCOMPRISING A MAGNETIC ELEMENT DRIVER”(包括磁性元件驱动器的手术缝合器械)、代理人案卷号为END6569USNP/090045的美国专利申请No._______。
在各种实施例中,参见图1A和1B,外科器械(例如外科器械100)可包括柄部组件102、从柄部组件102延伸的细长轴104和端部执行器106,如下文更详细描述的,端部执行器106可以相对于细长轴104运动或进行关节运动。在至少一个实施例中,柄部组件102可包括闭合触发器108,闭合触发器108可能够打开和关闭端部执行器106。更具体地讲,端部执行器106可包括砧座114,另外,细长轴104可包括闭合管112,其中致动闭合触发器108可以纵向运动闭合管112,以便使砧座114相对于钉仓通道113和钉仓115在打开位置和关闭位置之间旋转。在至少一个实施例中,闭合管112可能够相对于细长轴104的固定部分(例如脊116(图1B))滑动。在某些实施例中,端部执行器106还可包括管部分(例如远侧管部分118),所述管部分可以被闭合管112运动,以打开和/或关闭砧座114。在至少一个实施例中,外科器械100还可包括一个或多个枢转连接件211(图2和3),枢转连接件211可能够将闭合管112连接到远侧管部分118,并在端部执行器106相对于细长轴104进行关节运动时允许远侧管部分118相对于闭合管112进行关节运动。在任何情况下,一旦闭合了砧座114,即可致动柄部组件112的击发触发器110,以使切割和/或缝合构件运动穿过端部执行器106,以便切割和/或缝合捕集在端部执行器106内的组织。在充分切割和/或缝合组织之后,可以释放闭合触发器108,以便在相对的纵向上运动闭合管112并打开砧座114。其他外科器械在公布于2008年10月28日的名称为“SURGICAL STAPLINGINSTRUMENT WITH A RETURN MECHANISM”(具有返回机构的手术缝合器械)的美国专利No.7,441,685中有所公开,该专利的全部公开内容据此以引用方式并入本文。更多的外科器械在提交于2008年1月10日的名称为“SURGICAL STAPLING INSTRUMENT WITH AGEARED RETURN MECHANISM”(具有齿轮传动式返回机构的手术缝合器械)的美国专利申请No.12/008,303和提交于2008年1月10日的名称为“SURGICAL STAPLING INSTRUMENT WITH A FIRINGMEMBER RETURN MECHANISM”(具有击发构件返回机构的手术缝合器械)的美国专利申请No.12/008,266中有所公开,这些专利的全部公开内容均据此以引用方式并入本文。
在各种实施例中,再次参见图1A和1B,外科器械还可包括关节接头(例如关节接头120),关节接头120可能够允许端部执行器106相对于细长轴104运动。在至少一个实施例中,端部执行器106还可包括枢转板122,枢转板122能够被通道销124保持在钉仓通道113内。如图1B所示,通道销124可以插入、压力配合和/或搭扣配合到钉仓通道113的孔111和枢转板122的孔121内和/或穿过这些孔,以将枢转板122固定到钉仓通道113。在某些实施例中,枢转板122可以固定不动地保持在钉仓通道113内。此外,细长轴104还可包括销插板126,销插板126能够被脊116固定就位,在至少一个实施例中,销插板126可以固定不动地保持在细长轴104内。主要参见图1B,枢转板122还可包括销孔123,销孔123可能够接纳从销插板126延伸的关节销127。在各种实施例中,关节销127和销孔123可具有合适的尺寸并能够限定轴线,例如轴线128,使得钉仓通道113和枢转板122可以相对于销插板126围绕该轴线旋转。由于上述原因,端部执行器106可以相对于细长轴104进行关节运动,以便将端部执行器106适当地定位在(例如)手术部位内。一旦适当地定位,端部执行器106即能够相对于细长轴104锁定就位。在某些实施例中,细长轴104还可包括锁或制动器(例如锁130),锁130可能够有选择地接合例如枢转板122,并将枢转板122相对于销插板126固定就位。在至少一个这样的实施例中,枢转板122可包括一个或多个齿125,齿125可以被捕集到锁130远端的一个或多个凹槽131内或与凹槽131啮合,使得可以防止或至少限制齿125和凹槽131之间的相对运动。
在使用中,锁130可以脱离枢转板122,使得端部执行器106可以相对于细长轴104旋转。在至少一个这样的实施例中,一旦锁130脱离枢转板122,端部执行器106即可紧贴手术部位内的腔壁(例如腹膜腔壁)放置,并且可以通过柄部组件102向细长轴104施加纵向力,以使端部执行器106相对于细长轴104旋转。在某些情况下,这种关节运动可以被称为被动关节运动。在任何情况下,一旦使端部执行器106适当地进行了关节运动,即可将锁130与枢转板122重新接合,并可通过触发器108纵向推进闭合管112,以便如上所述闭合砧座114。读者会注意到,当端部执行器106在平直位置(即,其与细长轴104对齐或至少大致对齐的位置)和关节运动位置之间运动时,远侧管部分118可以在相对于闭合管112成第一角度的位置和相对于闭合管112成第二或不同角度的位置之间运动。为了适应这种相对运动,参见图2和3,枢转连接件211可以通过从枢转连接件211延伸的销凸起109和在远侧管部分118及闭合管112内的孔107可枢转地连接到远侧管部分118和闭合管112。销凸起109和销孔107可能够使得枢转连接件211可以在远侧管部分118和闭合管112之间提供至少一个自由度。在这样的实施例中,枢转连接件211可以允许远侧管118相对于闭合管112进行关节运动,即使已将闭合管112的至少一部分向远侧推进经过关节接头120。在任何情况下,一旦适当地闭合了砧座114,即可致动触发器110,以将击发杆向远侧推入端部执行器106内。虽然在图1A和1B中未示出击发杆,但外科器械200(参见图2-4)包括合适的击发杆250和切割构件252,它们可能够推入和/或位于端部执行器106内。在至少一个实施例中,例如外科器械100的细长轴和/或端部执行器可包括一个或多个狭槽,所述狭槽能够用于在外科器械100的轴和/或端部执行器内推进和/或收回击发杆250和/或切割构件252时,接纳和/或引导击发杆250和/或切割构件252。
在各种实施例中,参见图2-4,外科器械(例如外科器械200)可包括细长轴204和端部执行器206,其中端部执行器206可能够相对于细长轴204围绕关节接头220进行关节运动。类似于外科器械100,端部执行器206可包括保持在钉仓通道213内的枢转板222,其中枢转板222可包括销孔223,销孔223能够接纳从销插板226延伸的关节销227。在各种实施例中,主要参见图4,细长轴204还可包括一个或多个致动器,所述致动器可能够使端部执行器206相对于轴204旋转或枢转。在至少一个这样的实施例中,细长轴204还可包括安装在其中的第一螺线管240和第二螺线管242,这两个螺线管可与枢转板222可操作地接合,使得致动第一螺线管240和/或第二螺线管242可以使枢转板222围绕(例如)轴线旋转。在某些实施例中,第一螺线管240可包括活塞和/或杆241,活塞和/或杆241被充分安装到枢转板222,使得枢转板222可以被第一螺线管240向远侧推动和/或向近侧拉动,以使端部执行器206沿顺时针(CW)和/或逆时针(CCW)方向旋转。在某些情况下,这种关节运动可以被称为主动关节运动。
在各种实施例中,除了上述之外,可以在箭头“D”所指方向上向远侧推进杆241,以便沿箭头“CW”所指的顺时针方向旋转端部执行器206。要沿箭头“CCW”所指的逆时针方向旋转端部执行器206,则可以在箭头“P”所指方向上向近侧收回杆241。在某些实施例中,杆241可包括远端245,远端245可以定位在枢转板222的孔246内,使得杆241可以相对于枢转板222枢转。在至少一个实施例中,杆241可以适当地具有柔性,以适应枢转板222和螺线管240之间的相对运动。在某些实施例中,螺线管240可以可滑动和/或可旋转地安装在细长轴204内,使得杆241在伸展或收回以围绕轴线驱动枢转板222时不会不当地弯曲或粘着。在任何情况下,参见图3,螺线管240可包括线圈或绕组247,线圈或绕组247能够被电流和/或电压激活,以产生足以使杆241在远侧和/或近侧方向上运动的磁场,具体的运动方向取决于电流的流向和/或施加到绕组的电压的极性。在至少一个这样的实施例中,活塞和/或杆241可包括(例如)铁芯,所述铁芯可能够与螺线管绕组247产生的磁场相互作用。
在某些实施例中,除了上述之外,细长轴204可包括至少一个附加的螺线管,例如螺线管242,螺线管242可能够与螺线管240同时和/或独立地使枢转板222旋转。在至少一个这样的实施例中,螺线管242可包括活塞和/或杆243,活塞和/或杆243可以向远侧和/或近侧推进,以使端部执行器206沿顺时针和/或顺时针方向旋转。与螺线管240相反,杆243可以向远侧伸展以使枢转板222沿逆时针方向旋转,和/或可以向近侧收回以使枢转板222沿顺时针方向旋转。类似于螺线管240,杆243可包括远端245,远端245可以可枢转地安装在枢转板222内的孔246中。同样类似于螺线管240,螺线管242可以可旋转和/或可滑动地安装在细长轴204内,以便为包括枢转板222、销插板226、螺线管242和杆243的一系列连接件增加至少一个自由度,从而允许在端部执行器206和轴204之间进行关节运动。
如上所述,在端部执行器适当地进行关节运动之后,可以将外科器械的端部执行器锁定就位。在各种实施例中,参见图5和6,外科器械(例如外科器械300)可包括细长轴304和端部执行器306,其中端部执行器306可能够相对于细长轴304围绕关节接头320进行关节运动。类似于外科器械100,端部执行器306可包括保持在钉仓通道313内的枢转板322,其中枢转板322可包括销孔323,销孔323能够接纳从保持在细长轴304内的销插板326延伸的关节销327。在某些实施例中,细长轴304还可包括锁或制动器以及锁致动器,所述锁致动器可能够使锁与枢转板322接合,从而使枢转板322相对于细长轴304保持位置。在至少一个实施例中,细长轴304可包括锁致动器332,锁致动器332可能够向远侧运动锁330以使锁330与板322接合,和/或用于向近侧运动锁330以使锁330脱离板322。在至少一个这样的实施例中,锁致动器332可包括安装在细长轴304内的螺线管,其中所述螺线管可包括活塞和/或杆333,活塞和/或杆333可以被线圈或绕组334向远侧伸展和/或向近侧收回。在某些实施例中,锁330可以安装到杆333上,使得杆333的运动可以使锁330朝着和/或远离枢转板322运动。与上述类似,锁330可以被偏置成接触枢转板322,使得锁330远端内的凹槽331可以与从枢转板322延伸的凸起或齿325接合或啮合。在至少一个实施例中,锁致动器332还可包括偏置元件(例如弹簧335),所述偏置元件可能够将锁330偏置成与枢转板322接合。在至少一个这样的实施例中,锁致动器332的螺线管可以克服弹簧335所施加的偏置力,从而使锁330脱离枢转板322。在某些实施例中,弹簧335可以被压缩在从锁330延伸的凸缘336和细长轴306内固定的或至少大致固定的凸缘337之间,使得弹簧335可以向锁330施加偏置力。在至少一个实施例中,弹簧335可包括线性弹簧,其中,该弹簧所施加的力可以与弹簧的压缩距离成比例。
在各种实施例中,参见图7和8,外科器械(例如外科器械400)可包括一个或多个电机,所述电机能够使外科器械的端部执行器进行关节运动。在这样的实施例中,电机可包括(例如)感应电机、无刷直流电机、步进电机和/或同步电机。在某些实施例中,外科器械400可包括细长轴404和端部执行器406,其中端部执行器406可能够相对于细长轴404围绕关节接头420进行关节运动。类似于外科器械100,端部执行器406可包括保持在钉仓通道413内的枢转板422,其中枢转板422可包括销孔423,销孔423能够接纳从保持在细长轴404内的销插板426延伸的关节销427。在至少一个实施例中,细长轴404还可包括安装在其中的电机(例如电机440),电机440可以与枢转板422可操作地接合,以使端部执行器406相对于轴404旋转或进行关节运动。更具体地讲,在至少一个这样的实施例中,电机440可能够使齿轮(例如正齿轮439)旋转,正齿轮439可以与枢转板422上的一个或多个齿(例如齿429)啮合,使得正齿轮439的旋转可以传递到枢转板422。在至少一个这样的实施例中,齿429可以被布置成围绕枢转板422的周边的至少部分为环形的阵列。在各种实施例中,细长轴404还可包括齿轮箱(例如齿轮箱441),用于减小和/或增加由电机440驱动的输入轴和驱动正齿轮439的输出轴之间的齿轮齿数比。
与上述类似,外科器械(例如外科器械500)可包括一个或多个电机,所述电机能够利用蜗杆传动装置使外科器械的端部执行器进行关节运动。在各种实施例中,外科器械500可包括细长轴504和端部执行器506,其中端部执行器506可能够相对于细长轴504围绕关节接头520进行关节运动。类似于外科器械400,端部执行器506可包括保持在钉仓通道513内的枢转板522,其中枢转板522可包括销孔523,销孔523能够接纳从保持在细长轴504内的销插板526延伸的关节销。在至少一个实施例中,细长轴504还可包括安装在其中的电机(例如电机540),电机540可以与枢转板522可操作地接合,以使端部执行器506相对于轴504旋转或进行关节运动。更具体地讲,在至少一个这样的实施例中,电机540可能够使蜗杆(例如蜗杆539)旋转,蜗杆539可以与枢转板522上的蜗轮或凹型蜗轮部分529啮合,使得蜗杆539的旋转可以传递到枢转板522。蜗杆传动装置(例如上述类型)可以提供非常大的齿轮齿数比,使得不需要齿轮箱来降低电机的转速,然而也可以使用齿轮箱。在某些实施例中,蜗杆传动装置可以是自锁定的。更具体地讲,蜗杆539上的螺旋螺纹的导入角可以使得端部执行器506和蜗轮部分529不能以反向驱动蜗杆539和电机540的方式旋转。换句话讲,蜗轮部分529和蜗杆539可以能够使得在向端部执行器506施加旋转力时蜗轮部分529和蜗杆539摩擦锁定在一起。在某些实施例中,作为结果,端部执行器506相对于细长轴504的关节运动只能通过由电机540沿顺时针和逆时针方向有选择地旋转蜗杆539来控制,以便使端部执行器506例如在左右方向围绕关节接头520旋转。在至少一个这样的实施例中,可以不需要单独的关节运动锁(例如上文所述类型),但也可以使用关节运动锁。
在各种实施例中,外科器械(例如外科器械600)的细长轴的至少一部分可包括电机,所述电机能够使外科器械的端部执行器进行关节运动。在各种实施例中,参见图12-15,外科器械600可包括细长轴604和端部执行器606,其中端部执行器606可能够相对于细长轴604围绕关节接头620进行关节运动。在各种实施例中,端部执行器606还可包括安装在其中的枢转构件622,其中在至少一些实施例中,枢转构件622可以固定不动地安装在端部执行器606内。此外,细长轴604可包括一个或多个电机(例如电机640),所述电机可能够使枢转构件622围绕由枢转销627a和627b限定的轴线旋转。在至少一个实施例中,电机640可包括安装在细长轴604内的脊部616以及安装到脊部616的枢转销构件626,其中脊部616和枢转销构件626可以固定不动地安装在细长轴604内。参见图15,枢转销构件626可包括从其延伸的上尖齿626a和下尖齿626b,其中枢转销627a和627b可以分别从尖齿626a和626b延伸,并且可以任何合适的方式(例如通过压力配合关系和/或粘合剂)安装在尖齿626a和626b内的孔627c中。在各种实施例中,枢转构件622可包括一个或多个孔(例如孔623),孔623能够紧密地接纳枢转销627a和627b,使得枢转构件622和端部执行器606可以围绕如上所述轴线旋转或进行关节运动。
在各种实施例中,除了上述之外,脊部616和/或枢转销构件626可包括一个或多个孔或凹陷(例如孔651),孔651可能够接纳安装在其中的一个或多个电磁体,例如电磁体647。虽然未示出,但外科器械600还可包括一个或多个导体(例如绝缘线),所述绝缘线可能够:当把电流源和/或电压源(例如电池)可操作地连接到其上时,可通过线传导电流。在至少一个这样的实施例中,导体可以从外科器械的柄部组件(例如柄部组件102)延伸至细长轴606的远端,其中导体可以缠绕或盘绕在铁磁芯周围,所述铁磁芯可由(例如)铁和/或钴构成,以构成电磁体647a和647b。在使用中,在至少一个实施例中,外科器械还可包括开关或致动器,开关或致动器能够被操作,以有选择地将电流源和/或电压源连接到导体。在某些实施例中,当电流不流过导体时,电磁体647a、647b可能不产生磁场,而当充足的电流流过导体时,电流可以产生可用来旋转驱动器639的一个或多个磁场。主要参见图15,驱动器639可包括安装到其上的一个或多个磁性元件,当暴露于电磁体647产生的一个或多个磁场时,这些磁性元件可以与一个或多个磁场相互作用,并使驱动器639旋转。在至少一个这样的实施例中,驱动器639可包括一个或多个孔或凹陷(例如孔648),孔648可能够在其中接纳一个或多个永久磁体649。
在各种实施例中,除了上述之外,永久磁体649可具有磁极性,而不论其是否存在于磁场中。在至少一个实施例中,每个永久磁体649可包括正极或北极649n和负极或南极649s,其中极649n和649s可以被布置为使得当电磁体647a和647b有选择地产生一个或多个磁场时,这些磁场可以与永久磁体649产生的磁场相互作用,从而旋转驱动器639。在各种实施例中,驱动器639可以被紧密地接纳和可旋转地支撑在脊616中的孔654内,使得当永久磁体649在电磁体647a、647b产生的磁场内移位时,驱动器639可以围绕轴线旋转。如上文所概述的,可以有选择地对电磁体647a和647b通电以产生磁场,该磁场由于永久磁体649的极性会使永久磁体649在磁场内运动。在各种实施例中,可以对电磁体647a和647b通电,使得电磁体647a具有与电磁体647b的极性不同的极性。在至少一个实施例中,可以对电磁体647a和647b通电,使得它们具有相反的极性或不同的正(北)极和负(南)极,并使得电磁体647a和647b的两极被布置成交替的方式。在各种实施例中,流过缠绕在电磁体647a、647b的芯周围的导体的电流的方向可以确定电磁体产生的一个或多个磁场的极性。在使用中,可以反复切换或更替流过如上所述导体的电流的方向,使得可以反复切换或更替电磁体647a和647b中的一个或多个的极性,以便以某种方式吸引和/或排斥永久磁体649,使得驱动器639可以沿(例如)顺时针和/或逆时针方向连续旋转。
如上所述,永久磁体647a、647b的操作可以沿顺时针和/或逆时针方向旋转驱动器639。在各种实施例中,驱动器639还可包括一个或多个齿轮部分或驱动齿,所述齿轮部分或驱动齿可能够与枢转构件622上对应的齿轮部分或驱动齿啮合或配合。更具体地讲,在至少一个实施例中,驱动器639可包括从其上延伸的第一齿轮部分639a,第一齿轮部分639a可能够与从枢转构件622上延伸的第一齿轮部分629a啮合,使得当驱动器639如上所述旋转时,第一齿轮部分639a可以驱动第一齿轮部分629a,以使枢转构件622(并相应地使端部执行器606)围绕枢转销627a和627b枢转或进行关节运动。在至少一个这样的实施例中,主要参见图14,驱动器639可以在箭头D1所指示的第一方向上旋转,以使端部执行器606在箭头CW所指示的顺时针方向上旋转;此外,驱动器639可以在箭头D2所指示的第二方向上旋转,以使端部执行器606在箭头CCW所指示的逆时针方向上旋转。因此,在至少一个实施例中,驱动器639可以围绕第一轴线旋转,并且端部执行器606可以围绕第二轴线旋转,其中第一轴线和第二轴线可以彼此垂直或至少大致垂直。在其他实施例中,第一轴线和第二轴线可以彼此不平行、交叉和/或交错。在各种实施例中,再次参见图14,驱动器639还可包括第二齿轮部分639b,第二齿轮部分639b可以通过传动齿轮653与枢转构件622的第二齿轮部分629b可操作地啮合。在至少一个这样的实施例中,传动齿轮653可以通过销(例如销655)可旋转地安装到枢转销构件626,使得当驱动器639在如上所述D1方向上旋转时,第二齿轮部分639b可以协助第一齿轮部分639a使枢转构件622在(例如)顺时针CW方向上旋转。
如上文所概述的,外科器械可包括用于操作外科器械的柄部组件。在各种实施例中,现在参见图16和17,外科器械(例如外科器械700)可包括机架701、可枢转地安装到机架701的闭合触发器108,以及同样可枢转地安装到机架701的击发触发器110。类似于外科器械100,闭合触发器108及与之相关的闭合驱动器的操作可以使闭合管712沿细长轴704纵向运动,以便打开和关闭砧座114。在某些实施例中,现在主要参见图17,闭合驱动器可包括可滑动地定位在机架701内的止动环108b,以及可枢转地安装到止动环108b和触发器108的闭合连接件108a。在至少一个这样的实施例中,闭合管712的至少一部分可以保持在止动环108b内,使得闭合触发器108朝手枪式握把103的旋转可以向远侧(即箭头D所指方向)运动闭合连接件108a、止动环108b和闭合管712。
除了上述闭合驱动器之外,柄部组件702还可包括关节运动系统,所述关节运动系统能够使驱动器(例如驱动器739)旋转,以便使端部执行器706相对于细长轴704进行关节运动。在至少一个这样的实施例中,柄部组件702还可包括可在锁紧位置和解锁位置之间运动的关节运动旋钮760,其中在某些实施例中,主要参见图17,关节运动旋钮760可以在锁定到旋转钮770的第一或远侧位置和从旋转钮770上解锁的第二或近侧位置之间滑动。主要参见图19,关节运动旋钮760可包括一个或多个锁紧齿或凸起761,锁紧齿或凸起761可能够与旋转钮770上的一个或多个锁紧齿或凸起771接合,使得当关节运动旋钮760被定位在其锁紧或远侧位置时,关节运动旋钮760不能相对于旋转钮770旋转。因此,在至少一个这样的实施例中,当关节运动旋钮760在其锁紧位置时,不能利用关节运动旋钮760来旋转驱动器739并使端部执行器706进行关节运动。
除了上述之外,当关节运动旋钮760运动至其解锁或近侧位置时,锁紧齿761可以充分脱离锁紧齿771,使得关节运动旋钮760可以相对于旋转钮770旋转。在至少一个这样的实施例中,再次参见图16,关节运动旋钮760可以在箭头D1所指示的第一方向上旋转,以使端部执行器706在箭头CW所指示的顺时针方向上旋转;相应地,关节运动旋钮760可以在箭头D2所指示的第二方向上旋转,以使端部执行器706在例如箭头CCW所指示的逆时针方向上旋转。主要参见图18,关节运动旋钮760可以与花键环763可操作地接合,使得当关节运动旋钮760旋转时,花键环763可以被关节运动旋钮760旋转。在至少一个这样的实施例中,参见图18,花键环763可包括一个或多个花键764,花键764可能够允许关节运动旋钮760在其锁紧位置和解锁位置之间滑动,并且将旋转运动传递到花键环763。在各种实施例中,现在参见图19,花键环763可包括两个或更多个部分,这些部分可以组装到一起,使得花键环763包围闭合管712的至少一部分。在至少一个这样的实施例中,闭合管712可包括孔或窗口765,孔或窗口765可能够允许花键环763的至少一部分延伸穿过闭合管712并可操作地接合驱动器739。更具体地讲,花键环763还可包括从其延伸的一个或多个凸起或键766,凸起或键766可以被接纳在驱动器739内的一个或多个孔767中,使得当花键环763被关节运动旋钮760旋转时,花键环763可以使驱动器739旋转。因此,在各种实施例中,当关节运动旋钮760在其解锁位置时,关节运动旋钮760和驱动器739可以相对于闭合管712和脊构件716旋转。
在使用中,如上文所概述的,可以向近侧拉动关节运动旋钮760,以使锁紧齿761脱离旋转钮770的锁紧齿771。在各种实施例中,大致参见图16,关节运动旋钮760还可包括从其延伸的唇缘769,其中在至少一个实施例中,唇缘769可能够允许外科医生用一个或多个手指抓住唇缘769,并向近侧拉动关节运动旋钮760。在这样的情况下,参见图17,关节运动旋钮760可以压缩定位在关节运动旋钮760和旋转钮770中间的偏置构件,例如弹簧768。在某些实施例中,关节运动旋钮760、驱动器739和端部执行器706可以能够使得当关节运动旋钮760例如在D1方向上大致旋转10度时,端部执行器706可以在CW方向上大致旋转10度。可以将这样的实施例称为具有1∶1的齿轮齿数比,但也可以设想可具有更小或更大齿轮齿数比的其他实施例。在任何情况下,一旦端部执行器706发生令人满意的关节运动,外科医生即可释放关节运动旋钮760,使得弹簧768可以再次将关节运动旋钮760从其解锁位置运动到其锁紧位置。参见图19,锁紧齿761和/或锁紧齿771各自可包括一系列齿,这些齿可以能够使得锁紧齿761和771中的至少一些可以互相啮合或互锁,而不考虑关节运动旋钮760相对于旋转钮770的旋转程度。在图示的实施例中,齿761和齿771各自被布置成环形或至少大体上环形且同心或至少大体上同心的阵列。
在各种实施例中,除了上述之外,旋转钮770可能够使端部执行器706围绕纵向轴线(例如纵向轴线799)旋转。在至少一个这样的实施例中,主要参见图17,旋转钮770可以在锁定到机架701的远侧锁紧位置和从机架701上解锁的近侧解锁位置之间运动。在各种实施例中,再次参见图17,旋转钮770还可包括从其延伸的唇缘779,其中在至少一个实施例中,唇缘779可能够允许外科医生用一个或多个手指抓住唇缘779,并向近侧拉动旋转钮770。与上述类似,主要参见图19,旋转钮770可包括一个或多个锁紧齿或凸起772,锁紧齿或凸起772可能够与机架701上的一个或多个锁紧齿或凸起773接合,使得当旋转钮770被定位在其锁紧或远侧位置时,旋转钮770不能相对于机架701旋转。然而,当旋转钮770从机架701上解锁时,旋转钮770可以相对于机架701旋转,以使端部执行器706围绕纵向轴线799旋转。更具体地讲,在至少一个实施例中,旋转钮770还可包括一个或多个驱动部分(例如平驱动部分774),平驱动部分774可能够通过脊部716上对应的平坦部分775将旋转钮770的旋转传递到脊部716。在至少一个这样的实施例中,主要参见图19,平驱动部分774可能够延伸穿过闭合管712内的窗口765,以及驱动器739内的窗口776,使得平驱动部分774可以直接接合脊716上的平坦部分775。
除了上述之外,参见图17,旋转钮770可能够:当将旋转钮770向近侧拉入如上所述的解锁位置时,锁紧齿771可以通过锁紧齿761将旋转钮770的旋转传递到关节运动旋钮760。因此,在至少一个这样的实施例中,关节运动旋钮760可以与旋转钮770同步旋转,使得当旋转钮770处于其解锁位置时,脊构件716可以与驱动器739同步旋转。在至少一个实施例中,由于脊构件716和驱动器739的同步旋转,当旋转钮770相对于柄部机架701旋转时,端部执行器706可以不相对于细长轴704进行关节运动。换句话讲,当旋转钮770不相对于关节运动旋钮760旋转、并且驱动器739不相对于脊716旋转时,驱动器739可能无法使端部执行器706相对于轴704进行关节运动。在任何情况下,一旦端部执行器706围绕轴线799进行了适当的旋转,即可释放旋转钮770,以便将旋转钮770的锁紧齿772与柄部机架701的锁紧齿773重新啮合。在至少一个实施例中,参见图17-19,柄部组件702还可包括定位在旋转钮770和机架701中间的偏置构件(例如弹簧778),其中,当旋转钮770从其远侧锁紧位置运动至其近侧解锁位置时,弹簧778可以在旋转钮770和机架701之间压缩,并且当如上所述释放旋转钮770时,弹簧778可以将旋转钮770偏置为远离机架701,使得锁紧齿772与锁紧齿773重新啮合。再次参见图19,锁紧齿772和/或锁紧齿773各自可包括一系列齿,这些齿可以能够使得锁紧齿772和773中的至少一些可以互相啮合或互锁,而不考虑旋转钮770相对于机架701的旋转程度。在图示的实施例中,锁紧齿772和齿773各自被布置成环形或至少大体上环形且同心或至少大体上同心的阵列。
在各种实施例中,除了上述之外,外科医生可以一只手(如右手)握住柄部组件702并操作外科器械700。在至少一个实施例中,如上文所概述的,外科医生可以将其(例如)拇指放置在手枪式握把103的近侧面,并将其同一只手的一个或多个其余手指放置在触发器108和110的远侧面,以便向这些触发器施加力并将它们朝手枪式握把103拉动,从而将触发器108和110朝手枪式握把103收回。此外,如上文所概述的,外科医生可以将其同一只手的一个或多个其余手指向远侧延伸,以便抓住关节运动旋钮760的唇缘769和/或旋转钮770的唇缘779,并向近侧拉动这些唇缘。换句话讲,外科医生可以仅用一只手通过闭合触发器108打开和关闭砧座114、通过击发触发器110切割和缝合组织、使端部执行器706相对于细长轴704围绕关节接头720进行关节运动、以及使端部执行器706围绕纵向轴线799旋转。因此,外科医生可以在手术过程中腾出另一只手来进行其他任务。然而在许多情况下,尤其是当外科医生的手太小或因其他原因而不能进行上述任务时,旋钮760、770和触发器108、110的操作可能需要外科医生用两只手来操作外科器械,从而失去了一个或多个可能的优点。在各种可供选择的实施例中,现在参见图20和21,外科器械(例如外科器械800)可包括用于使端部执行器706相对于细长轴704进行关节运动的一系列磁性元件,以及用于使端部执行器706围绕纵向轴线799旋转的一系列磁性元件。在各种实施例中,外科器械800还可包括另外的一系列磁性元件,用来在锁紧位置和解锁位置之间运动关节运动旋钮760和旋转钮770。在任何情况下,外科器械800可以在许多方面类似于外科器械700,然而在下文中将更详细地讨论各种区别。
类似于外科器械700的关节运动旋钮760,现在参见图20,外科器械800的关节运动旋钮860可以在远侧锁紧位置和近侧解锁位置之间运动。同样类似于关节运动旋钮760,参见图21,关节运动旋钮860可包括锁紧齿761,当关节运动旋钮860在其锁紧位置和解锁位置之间运动时,锁紧齿761可以分别与旋转钮870上的锁紧齿762啮合和解除啮合。在各种实施例中,可以通过例如一系列电磁体881和磁性元件882将关节运动旋钮860往回或向近侧拉动。在至少一个实施例中,再次参见图21,可以将电磁体881以环形或至少大体上环形的阵列安装到旋转钮870,电磁体881可以与安装到关节运动旋钮860的具有环形或至少大体上环形的阵列的磁性元件882同心或至少大体上同心。在各种实施例中,外科医生可以操作例如柄部组件802上的开关,以将电流源和/或电压源设置成与电磁体881连通,使得电磁体881可以被充分通电或极化,以朝电磁体881吸引磁性元件882,并相应地向近侧运动关节运动旋钮860。在至少一个这样的实施例中,电磁体881可以向磁性元件882施加足够的磁动势(mmf),以充分运动关节运动旋钮860并使锁紧齿761脱离锁紧齿762,以使得关节运动旋钮860可以相对于旋转钮870旋转,如下文更详细描述的。在各种实施例中,与上述类似,可以在关节运动旋钮860和旋转钮870中间定位偏置构件(例如弹簧768),使得当关节运动旋钮860被电磁体881运动并保持在其近侧解锁位置时,弹簧768被压缩。在将电磁体881充分断电或去极化之后,弹簧768可能够将关节运动旋钮860偏置为返回其远侧锁紧位置。在各种实施例中,除了上述之外,磁性元件882可由(例如)铁和/或可与磁场相互作用的任何合适的铁磁材料构成。在至少一些实施例中,磁性元件882可包括永久磁体,例如钕磁体、钐钴磁体和/或任何合适的稀土磁体。在至少一个这样的实施例中,磁性元件882可以被布置和构造为吸引或排斥电磁体881的至少一部分,使得施加到电磁体881的磁动势可以预加载弹簧768和/或提供阻止关节运动旋钮860向近侧运动的阻力。
一旦关节运动旋钮860被充分解锁,如上所述,关节运动旋钮860即能够相对于旋转钮870旋转,以使端部执行器706相对于细长轴704进行关节运动。在各种实施例中,关节运动旋钮860可包括一个或多个磁性元件849,磁性元件849可能够与由安装到旋转钮870的一个或多个电磁体847产生的一个或多个磁场相互作用。在至少一个这样的实施例中,磁性元件849可由(例如)铁和/或任何其他合适的铁磁材料构成,并且可以嵌入和/或以其他方式适当地安装到关节运动旋钮860。在各种实施例中,电磁体847可以向磁性元件849施加磁动势(mmf),以使磁性元件849和关节运动旋钮860相对于电磁体847和旋转钮870运动。在至少一个实施例中,电磁体847的极性可以在第一极性和第二极性之间切换,以便沿箭头D1所指示的第一方向(图20)和/或箭头D2所指示的第二方向驱动关节运动旋钮860。在使用中,参见图20,外科医生可以致动开关869,以将电流源和/或电压源设置成与电磁体847连通,使得电磁体847可以产生足够的磁场,以使关节运动旋钮860在所需方向上相对于旋转钮870运动,从而使端部执行器706相对于细长轴704以与上文结合(例如)外科器械700所述相同或至少相似的方式进行关节运动。
类似于外科器械700的旋转钮770,外科器械800的旋转钮870可以在锁定到机架801的远侧位置和从机架801上解锁的近侧位置之间运动。在各种实施例中,除了上述之外,可以利用一系列(例如)电磁体和磁性元件将旋转钮870在其锁紧位置和解锁位置之间运动。在至少一个这样的实施例中,参见图21,机架801可包括安装在其上的多个电磁体886,电磁体886被布置成环形或至少大体上环形的阵列,其中电磁体886可能够产生一个或多个磁场,这些磁场能够吸引和/或排斥安装到旋转钮870的磁性元件887。与上述类似,电磁体886可以被充分通电或极化,以朝电磁体886拉动磁性元件887和旋转钮870,从而使锁紧齿772与机架701上的锁紧齿分离。一旦旋转钮870处于其解锁位置,即可通过另一系列电磁体和磁性元件使旋转钮870相对于机架801旋转。在至少一个这样的实施例中,再次参见图21,机架801可包括安装到其上的多个磁性元件880,磁性元件880可能够与电磁体847产生的一个或多个磁场相互作用。与上述类似,参见图20,外科医生可以操作开关879,以便有选择地激活或极化磁性元件847,从而产生用于使旋转钮870在第一方向上旋转的第一磁场和用于使旋转钮870在第二方向上旋转的第二磁场。在这样的实施例中,当旋转钮870被旋转时,旋转钮870可以使端部执行器706围绕纵向轴线799以与例如结合外科器械700的上述相同或至少相似的方式旋转。
虽然未示出,但读者将会知道,外科器械800的电磁体可以由共同的电源(例如电池)和/或不同的电源供电。再次参见图21,外科器械800还可包括一个或多个导体或线,用于放置与外科器械800的电磁体连通的一个或多个电源。在各种实施例中,柄部组件802还可包括一个或多个导体或线883,导体或线883可以为电磁体847提供电流和/或施加电压。在一些实施例中,虽然未示出,但导体883可具有充分的柔性和/或松弛度,以适应旋转钮870和机架801之间的相对运动。在其他实施例中,参见图21,柄部组件802可包括定位在机架801和旋转钮870中间的一个或多个电刷888,电刷888可能够在电源和电磁体847之间传导电流,而不论旋转钮870是否正相对于机架801运动,和/或不论旋转钮870和机架801之间的旋转度。在至少一个这样的实施例中,电刷888可以以环形或至少大体上环形的阵列定位在机架801和旋转钮870周围。在各种实施例中,电刷888可包括金属纤维刷(例如编织铜刷)、碳刷和/或任何其他合适的电刷。在至少一个实施例中,“电刷”可包括一个或多个材料块(例如碳块),材料块可能够传导电流和允许相对的“电刷”在其整个表面上相对滑动接触。在某些实施例中,“电刷”可包括任何合适的适形构件。在任何情况下,电刷888可具有足够的回弹力,使得当向远侧拉动旋转钮870时电刷可以弯曲或压缩,而当旋转钮870返回其锁紧位置时电刷可以重新伸展。
在各种实施例中,与上述类似,柄部组件802还可包括一个或多个导体或线884,导体或线884可以为电磁体881提供电流和/或施加电压。在一些实施例中,虽然未示出,但导体884可具有充分的柔性和/或松弛度,以适应旋转钮870和机架801之间的相对运动。在其他实施例中,与上述类似,柄部组件802可包括定位在机架801和旋转钮870中间的一个或多个电刷885,电刷885可能够在电源和电磁体881之间传导电流,而不论旋转钮860是否正相对于机架801运动,和/或不论旋转钮870和机架801之间的旋转度。与上述类似,电刷885包括金属纤维刷(例如编织铜刷)、碳刷和/或任何其他合适的电刷,这些电刷可具有足够的回弹力,使得当向远侧拉动旋转钮870时电刷可以弯曲或压缩,而当旋转钮870返回其锁紧位置时电刷可以重新伸展。除了上述之外,电刷885和/或电刷888可允许在电刷的两个半块之间相对滑动运动。更具体地讲,在至少一个实施例中,例如,电刷885可包括安装到旋转钮870且从其延伸出刷毛的第一半块,其中电刷885的第二半块可包括安装到机架801的一个或多个接触板,刷毛可以接触这些接触板并在接触板上滑动。在其他各种实施例中,例如,电刷885可包括各自具有从其延伸的刷毛的第一半块和第二半块,其中所述第一半块和第二半块可以安装到旋转钮870和机架801,并且可以彼此接触和在彼此上滑动。在任何情况下,电刷885可以以环形或至少大体上环形的阵列定位在机架801和旋转钮870周围。在各种实施例中,再次参见图21,柄部组件802可包括一个或多个导体或线889,导体或线889可以为电磁体886提供电流和/或施加电压。
在各种实施例中,外科器械可包括定位在细长轴内的一个或多个电磁体,其中所述电磁体可能够使外科器械的端部执行器相对于细长轴进行关节运动。在至少一个实施例中,参见图22-24,外科器械900可包括细长轴904和端部执行器906(图中所示移除了一些部分),其中端部执行器906可以通过关节接头920可枢转地连接到细长轴904。与上述类似,端部执行器906可包括枢转板922;此外,细长轴904可包括可通过脊916固定到细长轴904内的销插板926。同样与上述类似,销插板926可包括从其延伸的销,所述销可能够被紧密地接纳在枢转板922内的销孔123中。在某些实施例中,主要参见图23,细长轴904还可包括安装在其内的电磁体940a和940b;此外,枢转板922还可包括安装到其上的磁性元件949,其中电磁体940a、940b可能够产生一个或多个磁场,所述磁场可能够与磁性元件949相互作用,并使枢转板922和端部执行器906围绕由销插板926限定的轴线旋转。在各种实施例中,磁性元件949可包括磁体(例如稀土磁体),所述磁体可以被定位和布置在枢转板922上,使得磁体的极在预定取向上对齐。在至少一个实施例中,磁性元件949可以被布置为使得每个磁体的极被布置成端对端构型,使得每个磁体的正极或北极被定位成紧挨例如相邻磁体的负极或南极。可以设想其他实施例,其中磁体949的正极被定位成相对于例如其负极径向向外。
在使用中,在至少一个实施例中,可以对(例如)电磁体940b进行通电或极化,使得电磁体940b的远端包括磁场的正磁极或北磁极。在这样的情况下,可以使磁性元件949的正极被排斥远离电磁体940b,并使磁性元件949的负极被吸引朝向电磁体940b。因此,在各种实施例中,由例如电磁体940b产生的磁场可足以运动枢转板922和端部执行器906或使它们沿箭头CCW所指示的逆时针方向旋转。在至少一个这样的实施例中,参见图23,可以通过控制流过导体947b的电流量来控制由电磁体940b产生的磁场的强度,其中较大的电流可以产生较强的磁场,较小的电流可以产生较弱的磁场。在某些实施例中,与上述类似,供应到导体947b的电流的方向或施加到导体947b的电压的极性可以控制在电磁体940b远端处产生的磁极的极性。更具体地讲,如果流过导体947b的电流沿第一方向流动,则电流可以在芯941b的远端处产生正极;反之,如果流过导体947b的电流沿相反方向流动,则电流可以在芯941b的远端处产生负极。因此,在各种实施例中,流过导体947b的电流的方向可以选择性地变化,以选择性地改变由(例如)电磁体940b产生的磁场的极性。在至少一个这样的实施例中,电磁体940b远端的初始极性可以是(例如)正极,以便排斥第一磁体949,其中电磁体940b远端的极性可以接着从正极变为负极,以朝电磁体940b拉动紧挨的永久磁体949,从而继续使枢转板922和端部执行器906旋转。一旦第二永久磁体949充分定位,即可再次切换电磁体940b的极性(即从负极到正极),并且朝远离电磁体940b的方向排斥第二电磁体949,并再次继续使枢转板922和端部执行器906旋转。
在各种实施例中,可能期望的是限制端部执行器906可以相对于细长轴904旋转的范围。在某些实施例中,虽然未示出,但细长轴904可包括一个或多个阻挡件,所述阻挡件可能够当端部执行器906沿顺时针方向和/或逆时针方向运动时,阻挡其旋转。在至少一个这样的实施例中,阻挡件可以限制端部执行器906沿顺时针和/或逆时针方向的最大旋转度。在一些实施例中,参见图23,外科器械还可包括用于检测端部执行器906和细长轴904之间的位置或相对角度的装置,以及用于在端部执行器906已充分运动之后阻止端部执行器906旋转的装置。在至少一个这样的实施例中,细长轴904还可包括一个或多个传感器,所述传感器可能够检测端部执行器906上的一个或多个标记,以确定端部执行器906已相对于轴904旋转的量或角度。更具体地讲,在至少一个实施例中,细长轴904还可包括至少一个光电传感器(例如光电传感器991),光电传感器991可能够:当编码器标记990在端部执行器906旋转时经过光电传感器991下方时,用于检测编码器标记990。在各种实施例中,光电传感器991还可包括发光器;此外,编码器标记990可包括在枢转板922上至少部分地反射的表面,该表面可能够反射由发光器产生的光,以有利于检测编码器标记990。在某些实施例中,编码器标记990可以蚀刻到枢转板922上的表面内。在至少一个实施例中,虽然未示出,但端部执行器906可包括多个狭缝或孔,所述狭缝或孔被布置成与编码器标记990的布置方式类似的合适阵列,其中孔可能够允许从定位在枢转板922的相对侧或底侧上的光源发出的光穿过其中。在至少一个这样的实施例中,光源可包括一个或多个发光二极管。在某些其他实施例中,虽然未示出,但端部执行器和细长轴可包括当端部执行器旋转时转位的机械编码器。
在各种实施例中,主要参见图23,例如光电传感器991可以被设置成与控制单元(例如控制单元992)信号连通,使得与在光电传感器991下方经过的编码器标记990的数量相关的数据可以被传输到控制单元992。更具体地讲,在至少一个实施例中,控制单元992可包括至少一个数字信号处理器(例如DSP 993),DSP 993可能够接收来自光电传感器991的信号脉冲,该信号脉冲与编码器标记990在光电传感器991下方的经过相对应。例如,如果5个标记990从传感器991下方经过,则传感器991可以经导体994向DSP 993传输5个信号脉冲,然而这种通信可以是通过无线变送器(未示出)进行的无线通信。在任何情况下,DSP 993可能够处理此类信号脉冲、计算端部执行器906已相对于端部执行器904旋转的量、以及将此类信息输出给外科医生。在至少一个实施例中,除了上述之外,检测到一个编码器标记990可以表示端部执行器906进行了1度的关节运动,其中DSP 993可能够将端部执行器906已经旋转的角度传输至外科器械的柄部组件上的LCD显示器。在各种实施例中,LCD显示器可包括屏幕,屏幕中可以以数字、文本和/或图表(例如不断增加或不断减小的直线比例尺)形式显示数据。在各种实施例中,除了上述之外,控制单元992还可包括脉冲宽度调制器(PWM),脉冲宽度调制器可能够改变和控制提供给电磁体940a和940b的输出信号或功率。
如上所述,细长轴904可包括两个电磁体(即电磁体940a和940b),所述电磁体可能够产生可与磁性元件949相互作用的一个或多个磁场。如图23所示,枢转板922包括嵌入其中的5个磁性元件949;然而,其他实施例可具有5个以下磁性元件949或5个以上的磁性元件。相似地,其他外科器械可包括任何合适数量的电磁体。在至少一个实施例中,现在参见图25,外科器械1000的细长轴1004可包括4个电磁体(即电磁体1040a、1040b、1040c和1040d),这些电磁体可各自能够分别在芯1041a-1041d的远端处独立地产生磁场和极性。与上述类似,由电磁体1040a-1040d产生的磁场的强度和极性可以分别通过流过导体或线1041a-1041d的电流的方向和大小来确定。在任何情况下,一旦端部执行器906充分地进行了关节运动,与上述类似,即可将端部执行器106锁定就位。在各种实施例中,参见图23,细长轴904还可包括锁930,锁930可以在近侧解锁位置和远侧锁紧位置之间运动,其中在锁紧位置下,锁930与枢转板922上的齿925接合。在至少一个实施例中,锁930可包括多个凹陷931,凹陷931可能够接纳一个或多个齿925,使得枢转板922不能相对于锁930(相应地相对于细长轴904)旋转或至少大致旋转。相似地,锁930可包括定位在凹陷931中间的多个齿,所述齿可能够接纳在定位在枢转板922上的齿925中间的凹陷内。在各种实施例中,同样与上述类似,细长轴904还可包括锁致动器932,锁致动器932可能够使锁930在其锁紧位置和解锁位置之间运动。在至少一个这样的实施例中,锁致动器932可包括例如螺线管。
在各种实施例中,现在参见图27-32,外科器械(例如外科器械1100)可包括细长轴1104和端部执行器1106,其中端部执行器1106可能够相对于细长轴1104围绕关节接头1120进行关节运动。在至少一个实施例中,与上述类似,端部执行器1106可包括安装到其上的枢转板1122;此外,细长轴1104可包括安装在其内的销板构件1126,其中从销板构件1126延伸的销127可以被紧密地接纳在枢转板1122内的销孔123中,以限定轴线,使得枢转板1122和端部执行器1106可以相对于细长轴1104围绕该轴线进行关节运动。同样与上述类似,细长轴1104还可包括一个或多个电磁体,所述电磁体可能够产生一个或多个磁场,磁场可能够与安装到端部执行器1106的一个或多个磁性元件相互作用。在至少一个这样的实施例中,主要参见图28-31,端部执行器1106的枢转板1122可具有安装到其上的多个永久磁体1149,其中,在至少一个实施例中,永久磁体1149可以嵌入到枢转板1122内的一个或多个腔体中。在某些实施例中,与上述类似,永久磁体1149可具有正极和负极,所述正极和负极可以被布置成合适的方式,使得当安装在细长轴1104内的电磁体1141被充分通电或极化时,永久磁体1149可以与电磁体1141产生的一个或多个磁场相互作用。在至少一个这样的实施例中,永久磁体1149的正极可以被布置成使得其正极相对于其负极径向向外定位。换句话讲,在至少一个实施例中,永久磁体1149的正极可以被定位成邻近表面1125,而磁体1149的负极则可以相对于正极向远侧或至少一定程度上向远侧定位。在某些其他实施例中,永久磁体1141可以被布置成使其两极交替。例如,永久磁体1141能够被布置成使得第一磁体1141径向向外的端部为(例如)正极,第二磁体1141径向向外的端部为负极,第三磁体径向向外的端部为正极,依此类推。
在各种实施例中,除了上述之外,电磁体1141可以有选择地通电或极化,以收回或排斥永久磁体1149并使端部执行器1106在所需方向上旋转。在某些实施例中,参见图28和30,电磁体1141可以嵌入或定位在致动器构件1140中的一个或多个腔体内。在至少一个实施例中,可以对第一组电磁体1141进行通电或极化,使得它们的远端(即它们邻近永久磁体1149定位的端部)产生(例如)负极,而第二组电磁体1141可以保持未通电或未极化或至少基本上未通电或未极化。因此,在至少一个这样的实施例中,电磁体1141远端的负极性可以吸引永久磁体1149的正极,并将永久磁体1149朝电磁体1141的负极运动。在许多情况下,有选择地对第一组电磁体1141进行通电或极化可以运动永久磁体1149,使得端部执行器1106沿(例如)逆时针方向旋转。在某些情况下,可以接着将第一组电磁体1141断电或去极化或至少基本上断电或去极化,并且可以对第二组电磁体1141进行通电或极化,使得它们的远端产生负极性,与上述类似,该负极性吸引永久磁体1149的正极,以继续使端部执行器1106沿(例如)逆时针方向旋转。在某些其他实施例中,可以对第一组电磁体1141进行通电,使得它们的远端产生(例如)负极性;同时可以对第二组电磁体1141进行通电,使得它们的远端产生(例如)正极性。在各种实施例中,可以对第一组和第二组电磁体进行通电,使得它们同时或以合适的交替顺序具有不同的极性。
一旦端部执行器1106充分地进行了关节运动,除了上述以外,即可将端部执行器1106锁定就位。在各种实施例中,参见图28-30和32,细长轴1104还可包括锁1130,其中锁1130的至少一部分可以在远侧锁紧位置和近侧解锁位置之间运动,其中,其在远侧锁紧位置与(例如)枢转板1122接合,在近侧解锁位置与枢转板1122充分分离,以允许端部执行器1106围绕由销孔123和销127限定的轴线旋转。在至少一个实施例中,锁1130可包括活动的制动蹄(例如制动蹄1131),所述制动蹄可以在近侧位置和远侧位置之间运动。更具体地讲,在至少一个实施例中,枢转板1122可包括安装到其上的一个或多个永久磁体1138,其中永久磁体1138能够被构造和布置为使得它们的(例如)正极或北极相对于它们的负极或南极径向向外定位,并且其中永久磁体1138可能够朝枢转板1122吸引制动蹄1131,使得制动蹄1131接触制动面1125。在各种实施例中,制动蹄1131可包括安装到其上的一个或多个磁性元件1133,磁性元件1133可以与永久磁体1138产生的一个或多个磁场相互作用,其中所述一个或多个磁场可以向磁性元件1133施加足够的磁动势(mmf),使得制动蹄1131和制动面1125之间的支承力或制动力足以防止或至少抑制枢转板1122和枢转销构件1126之间的相对运动。
为了使制动蹄1131脱离枢转板1122,在各种实施例中,磁性元件1133可包括电磁体,可以有选择地对所述电磁体进行通电,以产生能使制动蹄1131远离枢转板1122运动的一个或多个磁场。在至少一种情况下,可以对电磁体1133进行通电,以在它们的远端(即它们最靠近枢转板122的端部)处产生正极,使得由电磁体1133产生的正极被永久磁体1138的正极排斥。在各种实施例中,可以将电磁体1133安装到制动蹄1131,使得当产生足够的磁动势时,制动蹄1131可以向近侧运动。制动蹄1131可以向近侧运动,使得制动蹄1131不再与制动面1125接合,和/或使得制动蹄1131因其他原因而不能向枢转板1122施加足以将端部执行器1106固定就位的制动力。在某些其他实施例中,永久磁体1138的负极可以径向向外定位,使得对电磁体1133进行通电时,在电磁体1133远端处产生的负极可以被永久磁体1138的负极排斥。在至少一个实施例中,主要参见图29和32,锁1130可包括一个或多个特征件,所述特征件用于限制制动蹄1131的运动,使得制动蹄1131沿预定路径(例如轴线1199)行进。在至少一个这样的实施例中,锁1130还可包括一个或多个凸起或行程限制器1130a,制动蹄1131还可包括止动臂1131a,其中行程限制器1130a和止动臂1131a可能够防止或至少抑制制动蹄1131和锁1130之间横向于轴线1199的相对运动。
在各种实施例中,除了上述之外,关节接头可包括第一和第二部分,第一和第二部分可能够相对于彼此进行关节运动。在各种其他实施例中,关节接头可包括能够相对于彼此进行关节运动的两个以上的部分。在至少一个这样的实施例中,参见图33-40,外科器械(例如外科器械1200)可包括柄部组件1202、细长轴1204和端部执行器1206,其中关节接头1220可能够允许端部执行器1206相对于细长轴1204旋转,并且其中关节接头1220可包括(例如)多个第一接头构件1222和多个第二接头构件1226。在某些实施例中,主要参见图34和35,第一接头构件1222和第二接头构件1226可以被布置成交替布置方式,其中,在至少一个实施例中,每个第一接头构件1222可包括安装到其上的一个或多个永久磁体,并且每个第二接头构件1226可包括安装到其上的一个或多个电磁体。现在参见图38和40,每个第一接头构件1222可包括定位在其中的孔(例如孔1248)内的第一永久磁体1249a,以及定位在另一个孔1248内的第二永久磁体1249b,其中另一个孔1248在第一接头构件1222的相对或至少基本上相对的一侧上。相似地,参见图36-40,每个第二接头构件1226可包括定位在其中的孔(例如孔1251)内的第一电磁体1240a,以及定位在另一个孔1251内的第二电磁体1240b,其中另一个孔1251在第二接头构件1226的相对或至少基本上相对的一侧上。在各种实施例中,再次参见图34和35,接头构件1222和1226能够被布置成使得永久磁体1249a与电磁体1240a对齐或至少大致对齐,并使得永久磁体1249b与电磁体1240b对齐或至少大致对齐。
在各种实施例中,除了上述之外,每个电磁体1240a可包括芯(例如芯1241a)和导体(例如导体1247a),其中导体1247a可能够当把电流源和/或电压源供应到导体1247a时传导电流,并且其中导体1247a的至少一部分可以缠绕在芯1241a周围,以产生具有极性的磁场。如上文所概述的,此类磁场的极性可以取决于电流流过导体1247a的方向。与上述类似,每个永久磁体1240b可包括芯(例如芯1241b)和导体(例如导体1247b),其中导体1247b可能够当把电流源和/或电压源供应到导体1247b时传导电流。在使用中,在至少一个实施例中,如图35所示,当把电流供应到和/或将电压施加到导体1247a使得电流以第一方向流过导体1247a时,端部执行器1206可以(例如)向右或沿顺时针方向进行关节运动。更具体地讲,再次参见图40,可对电磁体1240a进行通电或极化,使得永久磁体1249a标有“S”的负极或南极被吸引到由电磁体1240a产生的正极或北极;此外,永久磁体1249a标有“N”的正极被吸引到由电磁体1240a产生的负极。在这样的情况下,再次参见图35,在电磁体1240a和永久磁体1249a之间的磁动势(mmf)可足以使第一接头构件1222和第二接头构件1226相对于彼此进行关节运动。在某些实施例中,接头构件1222和1226可以相对于彼此进行关节运动,直到它们彼此邻接为止。在某些实施例中,如图33所示,当把电流供应到和/或将电压施加到导体1247a使得电流以第二方向或相反方向流过导体1247a时,端部执行器1206可以向左或沿逆时针方向进行关节运动。在这样的实施例中,再次参见图40,可对电磁体1240a进行通电或极化,使得永久磁体1249的负极被电磁体1240a产生的负极排斥;此外,永久磁体1249a的正极被电磁体1240a产生的正极排斥。
在各种实施例中,与上述类似,当把电流供应到和/或将电压施加到导体1247b使得电流以第一方向流过导体1247b时,端部执行器1206可以(例如)向左或沿逆时针方向进行关节运动。更具体地讲,再次参见图40,可对电磁体1240b进行通电或极化,使得永久磁体1249b标有“S”的负极或南极被吸引到由电磁体1240b产生的正极或北极;此外,永久磁体1249b标有“N”的正极被吸引到由电磁体1240b产生的负极。在这样的情况下,再次参见图33,在电磁体1240b和永久磁体1249b之间的磁动势(mmf)可足以使第一接头构件1222和第二接头构件1226相对于彼此进行关节运动。在某些实施例中,接头构件1222和1226可以相对于彼此进行关节运动,直到它们彼此邻接为止。同样与上述类似,如图35所示,当把电流供应到和/或将电压施加到导体1247b使得电流以第二方向或相反方向流过导体1247b时,端部执行器1206可以向右或沿顺时针方向进行关节运动。在这样的实施例中,再次参见图40,可对电磁体1240b进行通电或极化,使得永久磁体1249b的负极被电磁体1240b产生的负极排斥;此外,永久磁体1249b的正极被电磁体1240b产生的正极排斥。在各种实施例中,除了上述之外,端部执行器1206和/或细长轴1204可包括一个或多个永久磁体和/或电磁体,所述永久磁体和/或电磁体可能够使接头构件1222和/或1226中的一个或多个进行关节运动。
在各种实施例中,同样除了上述之外,可同时对关节接头1220内的(例如)每个电磁体1240a进行通电,以使端部执行器1206实现向右的最大关节运动。相似地,可以同时对(例如)每个电磁体1240b进行通电,以使端部执行器1206实现向左的最大关节运动。在至少一个实施例中,参见图35,关节接头1220可包括(例如)三个活动的第一接头构件1222和三个活动的第二接头构件1226。在至少一个这样的实施例中,六个接头构件中的每一个可能够相对于相邻的接头构件进行(例如)大约10度的关节运动,导致总共进行(例如)大约70度的关节运动。在某些实施例中,虽然未示出,但可以利用单个导体来对每个电磁体1240a进行通电或极化;此外,可利用单个导体来对每个电磁体1240b进行通电或极化。实际上,电磁体1240a能够被设置成彼此串联,相似地,电磁体1240b能够被设置成彼此串联。在某些其他实施例中,如图40所示,例如,每个电磁体1240a可独立于其他电磁体1240a进行通电;相似地,每个电磁体1240b可独立于其他电磁体1240b进行通电。在至少一个这样的实施例中,可有选择地致动电磁体1240a、1240b,使得端部执行器1206可以进行小于其最大关节运动的关节运动。例如,可以仅对一个电磁体1240a进行通电或极化,以使端部执行器1206进行大约20度的关节运动;可对两个电磁体1240a进行通电或极化,以使端部执行器1206进行大约40度的关节运动;并且可对三个电磁体1240a进行通电或极化,以使端部执行器1206进行大约70度的关节运动。在某些实施例中,端部执行器1206和/或细长轴1204可包括一个或多个电磁体,所述一个或多个电磁体能够被致动,以使端部执行器1206进行70度以上(例如大约80度)或小于20度的关节运动。
如上所述,每个电磁体1240a、1240b可分别包括可能够传导电流的导体1247a、1247b。在各种实施例中,导体1247a和1247b可包括(例如)线,所述线可足够柔软,以适应第一接头构件1222和第二接头构件1226之间的相对运动。在至少一个实施例中,导体1247a和1247b可延伸穿过接头构件1222和1226内的一个或多个通孔1298,其中导体1247a和1247b可具有足够的松弛度,使得它们在端部执行器1206进行关节运动时不会损坏。在至少一些实施例中,再次参见图36,第一接头构件1222和/或第二接头构件1226还可包括(例如)一个或多个槽1296,槽1296可能够接纳一个或多个导体1247a和/或1247b,使得导体可以被安放成与接头构件1222和1226的表面齐平和/或低于该表面。在各种实施例中,一个或多个导体(例如导体1247a和1247b)可延伸穿过接头构件1222和1226的通道1250。在至少一个这样的实施例中,通道1250可沿着关节接头的中轴线设置,使得可以将施加到导体1247a和1247b的应力和应变最小化。换句话讲,在至少一个实施例中,延伸穿过通道1250的路径可以限定穿过关节接头的长度,其中当端部执行器进行关节运动时,所述长度不会改变或至少不会显著改变,使得导体不会出现大的变形。
在各种实施例中,如上所述,第一接头构件1222可能够相对于第二接头构件1226进行关节运动,并且相应地,第二接头构件1226可能够相对于第一接头构件1222进行关节运动。在至少一个实施例中,再次参见图36-39,接头构件1222和1226可通过一个或多个球窝构造或接头连接到一起。更具体地讲,每个第一接头构件1222均可包括球构件1227,球构件1227可能够接纳在相邻的第二接头构件1226的承窝1223内。相似地,每个第二接头构件1226也可包括球构件1227,球构件1227可能够接纳在相邻的第一接头构件1222的承窝1223内。在至少一个这样的实施例中,球构件1227可以为球形或至少大致球形,承窝1223可包括半球形或至少部分为球形的腔体。在各种实施例中,球窝接头可能够允许第一接头构件1222和第二接头构件1226在左右方向、上下方向和/或任何其他合适的方向上运动。在各种实施例中,球构件1227和承窝1223可以限定通道1254,通道1254可能够可滑动地接纳击发构件1250(图35),并限定击发构件1250的路径,尤其是当端部执行器1206处于关节运动位置时。在某些实施例中,球窝接头中的一个或多个可能够限制在接头构件1222和1226之间的相对运动。在至少一个这样的实施例中,球窝接头中的一个或多个可能够限制第一接头构件和第二接头构件之间的相对运动,使得接头构件只能相对于彼此沿(例如)平面运动。再次参见图36,球构件1227可包括(例如)从其延伸的一个或多个对齐凸缘1224,现在参见图37和38,对齐凸缘1224可能够接纳在(例如)限定在承窝1223内的对齐凹槽1221中。在至少一个这样的实施例中,对齐凸缘1224和对齐凹槽1221可具有合适的尺寸,并能够限制第一接头构件1222和第二接头构件1226之间沿由(例如)对齐凸缘1224限定的平面的相对运动。
在任何情况下,除了上述之外,一个或多个第一接头构件1222和一个或多个第二接头构件1226在已经相对于彼此运动或进行关节运动之后可以沿轴线重新对齐。在至少一个实施例中,可以对(例如)电磁体1240a和1240b通电,以拉直关节接头1220,并且使端部执行器1206与轴1204重新对齐。更具体地讲,在至少一个实施例中,可以同时对电磁体1240a和电磁体1240b通电,使得第一接头构件1222和第二接头构件1226沿着由轴1204限定的中央轴线定位。在某些实施例中,提供给电磁体1240a和1240b的电流和/或功率的大小可以至少在开始不同,以将接头构件1222和1226运动至彼此大致对齐,其中,随后提供给电磁体1240a和1240b的电流和/或功率的大小可以相等或至少大致相等,使得接头构件1222和1226可以更准确地对齐。在某些实施例中,提供给电磁体1240a和1240b的电流和/或功率的大小开始可以相同或至少大致相同,尤其是在端部执行器1206尚未进行明显的关节运动时。
在各种实施例中,除了上述之外,外科器械的端部执行器可以在不止一个平面内进行关节运动。在至少一个实施例中,现在参见图41-45,外科器械1300可包括细长轴1304、端部执行器1306和关节接头1320,关节接头1320可能够允许端部执行器1306相对于轴1304进行关节运动。与关节接头1220类似,关节接头1320可包括多个第一接头构件1322和多个第二接头构件1326,第一接头构件1322和第二接头构件1326可能够相对于彼此进行关节运动。但与接头构件1222和1226不同,接头构件1322和1326不包括限制二者之间的相对运动的对齐特征件1221和1224。因此,在至少一个实施例中,端部执行器1306可以在多个方向和/或平面内进行关节运动。在某些实施例中,主要参见图41,每个第二接头构件1326可包括四个电磁体(例如,电磁体1340a、1340b、1340c和1340d),这些电磁体可以安装到第二接头构件1326的孔内。在至少一个这样的实施例中,电磁体1340a-1340d可以相对于彼此和相对于接头构件1326的中心等距离定位。相应地,参见图42,每个第一接头构件1322可包括四个永久磁体:永久磁体1349a、1349b、1349c(图41)和第四永久磁体(未示出),其中每个永久磁体1349a可以与一个或多个电磁体1340a对齐,其中每个永久磁体1349b可以与一个或多个电磁体1340b对齐,其中每个永久磁体1349c可以与一个或多个电磁体1340c对齐,并且其中每个第四永久磁体可以与一个或多个电磁体1340d对齐。
在使用中,与上述类似并参见图43,可以选择性地致动电磁体1340a和/或电磁体1340b,以使端部执行器1306相对于细长轴1304在左右方向进行关节运动。换句话讲,参见图44,端部执行器1306可以在左右方向相对于轴线1395v进行关节运动,其中在一些实施例中,轴线1395v可延伸穿过电磁体1340c和1340d,并可横向延伸至纵向轴线1399并与其相交。除了上述之外,可以选择性地致动电磁体1340c和/或电磁体1340d,以使端部执行器1306相对于细长轴1304在上下方向进行关节运动。换句话讲,端部执行器1306可以在上下方向相对于轴线1395h进行关节运动,其中在一些实施例中,轴线1395h可延伸穿过电磁体1340a和1340b,并可横向延伸至纵向轴线1399并与其相交。在各种实施例中,可以致动电磁体1390a、1390b、1390c和1390d的任何合适组合,以使端部执行器1306相对于细长轴1304在任何合适的方向上进行关节运动。例如,再次参见图44,可以致动电磁体1340b和1340c,以使端部执行器1306在沿轴线1395n的方向上进行关节运动。在这样的实施例中,流过导体1347b的电流大小可以与流过导体1347c的电流大小相同或至少大致相同,使得由电磁体1340b和1340c产生的磁场的强度可以相同或至少大致相同,从而向与其各自对齐的永久磁体施加相等或至少大致相等的磁动势。可以致动电磁体1340a和1340d,以使端部执行器1306在沿1395n的相反方向上进行关节运动。相似地,可以致动电磁体1340a和1340c,以使端部执行器1306在沿轴线1395p的方向上进行关节运动;此外,可以致动电磁体1340b和1340d,以使端部执行器1306在沿轴线1395p的相反方向上进行关节运动。
在各种实施例中,如上文所概述的,可以致动电磁体1340b和1340c,以使端部执行器1306在沿(例如)轴线1395n的方向上进行关节运动。在至少一个这样的实施例中,可以致动电磁体1340b和1340c,以便分别将永久磁体1349b和1349c吸引到其上。同时,在某些实施例中,可以致动电磁体1340a和1340d,以便分别排斥永久磁体1349a和1349d,从而有助于端部执行器1306进行关节运动。在各种实施例中,根据上述内容,可以致动电磁体的任何合适的组合,使得它们可以(例如)同时和/或以任何合适的顺序吸引和/或排斥与它们相关的各种永久磁体。
如上文所概述的,可以致动电磁体1340a、1340b、1340c和1340d的各种组合,以使端部执行器1306进行关节运动,其中在一些实施例中,可以向致动的电磁体提供相同的电流量,以使端部执行器1306沿轴线1395n和1395p(即沿相对于例如轴线1395v和1395h大约45度的角度)进行关节运动。在其他实施例中,可以向各种电磁体提供不同的电流量,使得端部执行器1306在其他方向上进行关节运动。例如,可以向电磁体1340c的导体1347c提供电流,该电流的大小是向电磁体1340b的导体1347b提供的电流大小的大约两倍,以使端部执行器1306沿轴线1395n和1395v中间的方向进行关节运动。在任何情况下,可以全部同时致动电磁体1340a、1340b、1340c和1340d,以便沿着(例如)纵向轴线1399重新拉直关节接头1320。在某些实施例中,再次参见图41和43,关节接头1320还可包括一个或多个柔性的拉直对齐杆(例如杆1343),杆1343可能够将关节接头1320拉直。在至少一个这样的实施例中,杆1343的近端可以安装到细长轴1304,其中杆1343可延伸穿过接头构件1322和1326内的孔1346,并延伸进入端部执行器1306内的孔1397。当端部执行器1306如上所述进行关节运动时,杆1343可以足够柔韧以允许这种关节运动,但可以具有足够的回弹力,以便在电磁体1340a、1340b、1340c和1340d被充分断电之后恢复其初始形状。在至少一个实施例中,杆1343可能够在孔1346和孔1397内滑动,以适应关节接头1320的各种构型。与上述类似,参见图41和45,接头构件1322和1326可包括一个或多个通孔1398a-1398d,所述通孔可能够在其中可滑动地接纳导体1347a-1347d,其中导体1347a-1347d也可以足够柔韧以适应关节接头1320的各种构型。
如上所述,可利用一系列永久磁体和电磁体来使端部执行器相对于外科器械的细长轴进行关节运动。在各种实施例中,外科器械可包括一系列永久磁体和电磁体,这些永久磁体和电磁体能够驱动切割构件和/或缝钉驱动器穿过外科器械的端部执行器。在至少一个实施例中,参见图46-50,外科器械(例如外科器械1400)可包括端部执行器1406、细长轴1404和切割构件1452,切割构件1452能够在端部执行器1406内前进和/或回撤。主要参见图46和50,端部执行器1406可包括钉仓通道1413,钉仓通道1413能够在其中支撑和/或保持(例如)钉仓115。端部执行器1406还可包括砧座1414,砧座1414可以可旋转地连接到钉仓通道1413,使得砧座1414可以在打开位置和关闭位置之间旋转。如图46最佳示出的,砧座1414还可包括安装到其上的多个永久磁体1417,其中当砧座1414处于(例如)其关闭位置时,永久磁体1417可能够推进或收回切割构件1452。更具体地讲,在至少一个实施例中,切割构件1452可包括一个或多个电磁体1456(图48-50),可对电磁体1456进行通电或极化,以产生一个或多个可以与永久磁体1417相互作用的磁场,并在其间产生磁动势。在各种实施例中,磁动势可以使切割构件1452在端部执行器1406内向近侧和/或向远侧运动。在至少一个实施例中,永久磁体1417可以固定在砧座1414中等距或至少大致等距的孔内;此外,电磁体1456可以安装在上靴座1458内。在各种实施例中,参见图50,上靴座1458可能够接纳在砧座1414内的槽1405a中,使得当切割构件1452横跨砧座1414时,上靴座1458可以向下偏置砧座1414,以压缩定位在(例如)砧座1414和钉仓115中间的组织。
在各种实施例中,与上述类似,钉仓通道1413还可包括安装到其上的多个永久磁体1419,其中永久磁体1419可能够推进或收回切割构件1452。更具体地讲,在至少一个实施例中,切割构件1452可包括一个或多个电磁体1457,可对电磁体1457进行通电或极化,以产生一个或多个可以与永久磁体1419相互作用的磁场,并在其间产生磁动势。在各种实施例中,磁动势可以使切割构件1452在端部执行器1406内向近侧和/或向远侧运动。在至少一个实施例中,永久磁体1419可以固定在钉仓通道1413中等距或至少大致等距的孔内;此外,电磁体1457可以安装在下靴座1459内。在各种实施例中,参见图50,下靴座1459可能够接纳在钉仓115内的槽1405b中,使得当切割构件1452横跨钉仓115时,下靴座1459可以与上靴座1458配合,以压缩定位在(例如)砧座1414和钉仓115中间的组织。在某些实施例中,钉仓115、钉仓通道1413和/或砧座1414的各个部分可以由一种或多种非导电材料构成,该材料可具有足够的介电强度,以防止电流在电磁体之间和/或在电磁体与永久磁体之间流动,同时又可充分透过磁场。在任何情况下,与上述类似,外科器械1400还可包括一个或多个导体(例如线1484),线1484可能够为电磁体1456和/或1457提供电流,以选择性地极化电磁体1456和1457。在至少一个这样的实施例中,同样与上述类似,流过导体1484的电流的方向可以选择性地交替变化,以控制由电磁体1456和/或1457产生的极。在各种实施例中,导体1484的至少一部分可以嵌入击发杆1450内。在某些实施例中,击发杆1450可包括两个或更多个层合的层,其中虽然未示出,但导体1484的至少一部分可以定位在层中间,并且其中这些层可能够保护导体1484和/或使其电绝缘,以使导体1484不会意外地彼此接触和/或与外科器械1400的任何其他部分接触。在各种实施例中,虽然未示出,但导体1484可包括柔性带缆,柔性带缆可构成平行布置且彼此电绝缘的多个导体1484。在任何情况下,端部执行器1406内的该系列永久磁体和电磁体都可充分推进和收回切割构件1452,而不需要通过击发杆1450向切割构件1452传递额外的击发力,然而击发杆1450可能够向切割构件1452传递额外的击发力。
在各种实施例中,如上文所概述的,电磁体可以定位到在端部执行器内可活动的切割构件上面和/或内部。在使用中,可以致动电磁体或对其通电,使得它们可产生极化磁场。在至少一个这样的实施例中,每个电磁体都可包括布置成缠绕构型的至少一个导体,其中当向导体提供电流时,电流可以产生具有正极和负极的磁场。在某些实施例中,同样如上文所概述的,定位在缠绕的导体内的铁芯可以放大由电流产生的磁场。虽然电磁体完全适用于各种实施例,但也可使用能够有选择地产生一个或多个磁场的任何装置。在至少一个实施例中,例如,可极化的装置可包括环形或超环面的永久磁体和/或铁芯,其中导体可延伸穿过永久磁体和/或铁芯内的孔,并且其中由流过导体的电流产生的磁场可以被导体周围的环形铁芯放大。在多种情况下,由此类装置产生的磁场可足以产生如本文所述的可用磁动势。在某些实施例中,由霍尔效应装置或线圈产生的磁场可用来在端部执行器内运动(例如)切割构件。
在各种实施例中,除上述之外或替代地,外科器械可包括一系列永久磁体和电磁体,这些永久磁体和电磁体能够在外科器械的细长轴内推进和/或收回击发杆。现在参见图51A-51C和图53,外科器械1500可包括细长轴1504和击发杆1550,其中击发杆1550可以向远侧推进(图53)和/或向近侧收回(图51A-51C),以便在端部执行器内运动切割构件和/或缝钉驱动器(例如切割构件1452),从而(例如)切割组织和/或将缝钉布放到组织内。在某些实施例中,轴1504可包括脊1516,脊1516可包括能够允许击发杆1550在其中滑动的一个或多个狭槽。在至少一个这样的实施例中,细长轴1504还可包括安装到脊1516的一个或多个电磁体1556,电磁体1556可能够有选择地产生一个或多个磁场。与上述类似,此类磁场可与安装到击发杆1550的永久磁体1517相互作用,使得在电磁体1556和永久磁体1517之间产生的磁动势可以使永久磁体1517和击发杆1550相对于电磁体1556和脊1516运动。在至少一个实施例中,现在参见图52,细长轴1504可包括定位在击发杆1550一侧上的第一组电磁体1556和定位在击发杆1550相对侧上的第二组电磁体1556。相应地,第一组永久磁体1517可以定位在击发杆1550的第一侧面上,第二组永久磁体1517可以定位在击发杆1550的相对侧上。同样与上述类似,可以选择性地提供供往电磁体1556的电流,以便根据需要在电磁体1556内产生正极、负极和/或不产生极性,从而充分吸引和排斥永久磁体1517的正极和负极。在某些实施例中,再次参见图52,细长轴1504还可包括一个或多个导体1584,导体1584可能够向电磁体1556供应电流。在某些实施例中,导体1584可包括定位在脊1516和电磁体1556中间的带缆,其中脊1516可由(例如)非导电材料构成。
在各种实施例中,除了上述之外,外科器械可包括具有磁性元件(例如铁芯和/或永久磁体)和可选择性致动的电磁体的系统,其中该系统可包括线性电机,所述线性电机能够沿预定路径运动击发杆和/或切割构件,并且其中该路径可包括沿一个或多个方向的线性部分和/或弯曲部分。在各种实施例中,外科器械还可包括计算机或处理器,计算机或处理器可能够计算将供应到电磁体的电流的适当大小、持续时间和/或方向。在某些实施例中,外科器械还可包括一个或多个开关,所述开关可由计算机操作,以选择性地为一个或多个电磁体提供电流。在某些实施例中,虽然未示出,但外科器械可包括柄部、从柄部延伸的细长轴、以及可操作地连接到轴的端部执行器,其中轴可包括缠绕在轴线或轴内的预定路径周围的一个或多个导体。在至少一个这样的实施例中,可以将具有(例如)铁部分的击发杆或击发棒定位在由缠绕的导体限定的孔内,使得当把电流提供给导体时,由电流产生的一个或多个磁场可以沿预定路径运动铁击发杆。在至少一个实施例中,与上述类似,例如沿第一方向流过导体的电流可以在轴内向远侧运动击发杆;此外,沿相反方向流过导体的电流可以沿相反或近侧方向运动击发杆。
在各种实施例中,外科器械的细长轴可包括螺线管,所述螺线管能够推进和/或收回击发杆、切割构件和/或缝钉驱动器。在至少一个实施例中,参见图54和55,外科器械1600可包括柄部组件1602、细长轴1604和击发杆1650。与柄部组件102类似,柄部组件1602还可包括触发器(未示出),所述触发器能够推进和/或收回击发杆1650。在至少一个实施例中,柄部组件1602的触发器可能够在致动时闭合电路或使电路完整,其中闭合的电路可能够向可操作地接合到击发杆1650的螺线管供应电流。在某些实施例中,虽然未示出,但(例如)柄部组件1602可包括定位在其中的一个或多个电池,其中所述电池和一个或多个导体可能够向螺线管供应电流。在至少一个实施例中,螺线管可包括绕组1656,绕组1656能够被电流激活以产生极化的磁场。与上述类似,螺线管还可包括可由(例如)铁构成的磁性元件1617,磁性元件1617可能够与磁场相互作用。在使用中,如图55所示,可以将沿第一方向流动的电流供应到绕组1656,使得绕组1656产生的磁场可以在细长轴1604内向远侧推进磁性元件1617和安装到磁性元件上的击发杆1650。在某些实施例中,可以释放触发器,以断开供应到绕组1656的电流并停止推进击发杆1650。在至少一个这样的实施例中,柄部组件1602和/或细长轴1604可包括一个或多个弹簧(未示出),所述弹簧可能够偏置磁性元件1617和击发杆1650,使它们返回图54中所示的起始位置。在其他实施例中,在释放击发触发器时,可以逆转在绕组1656内流动的电流的方向,使得绕组1656产生的磁场的极性反转,并收回磁性元件1617。在其他实施例中,可以再次致动柄部组件1602的触发器,以逆转绕组1656内的电流的方向,并收回磁性元件1617。
在各种实施例中,虽然未示出,但外科器械可包括柄部、从柄部延伸的轴和可操作地连接到轴的端部执行器,其中所述轴可包括可旋转的驱动轴,并且其中外科器械还可包括能够使驱动轴旋转的电机。包括电机和可旋转驱动轴的各种外科器械在下列专利中有所公开:授予Shelton,IV等人、公开于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING FASTENING INSTRUMENT WITHTACTILE POSITION FEEDBACK”(具有触觉位置反馈的电动外科切割和紧固器械)的美国专利No.7,422,139;和授予Shelton,IV等人、公开于2008年8月28日的名称为“MOTOR-DRIVEN SURGICALCUTTING AND FASTENING INSTRUMENT WITH LOADING FORCEFEEDBACK”(具有载荷力反馈的电动外科切割和紧固器械)的美国专利No.7,416,101,这些专利的全部公开内容均以引用方式并入本文中。在至少一个实施例中,外科器械的电机可包括步进电机,所述步进电机可能够使驱动轴旋转经过预定范围的旋转度。在至少一个实施例中,可以将一个或多个磁性元件(例如铁芯)放置在驱动轴上或嵌入驱动轴,其中磁性元件可能够由(例如)定位在轴内的一个或多个传感器检测。在某些实施例中,此类传感器可包括霍尔效应传感器或线圈,所述霍尔效应传感器或线圈可能够检测一个或多个磁场内的中断,即由磁性元件形成的中断。
在各种实施例中,虽然未示出,但外科器械可包括一系列电磁体和磁性元件,这些电磁体和磁性元件可能够关闭和/或打开外科器械的端部执行器。在至少一个这样的实施例中,与上述类似,端部执行器可包括钉仓通道,所述钉仓通道能够接纳钉仓以及可旋转地连接到钉仓通道的砧座。在某些实施例中,可以在钉仓通道内定位一个或多个电磁体;此外,可以在砧座内定位一个或多个磁性元件,其中对电磁体进行通电或极化时,电磁体可以产生磁场,该磁场可使磁性元件朝电磁体运动,从而使砧座在打开位置和关闭位置之间运动。在一些这样的实施例中,电磁体的极性可以反转,以排斥安装到砧座的磁性元件,从而在关闭位置和打开位置之间运动砧座。在其他实施例中,可以充分减少或断开供应到电磁体的电流,使得电磁体无法产生足以将砧座保持在其关闭位置的磁场。在至少一个这样的实施例中,端部执行器还可包括弹簧,所述弹簧可能够将砧座偏置到其打开位置,使得当电磁体如上所述充分断电时,弹簧可以将砧座运动至其打开位置。在各种可供选择的实施中,电磁体可能够将砧座偏置到其打开位置,并且弹簧可能够将砧座偏置到其关闭位置。
虽然已经通过描述几个实施例显示了本发明,虽然已经相当详细地描述了示例性实施例,但是申请人的意图不在于将所附权利要求的范围约束或以任何方式限制到这些细节中。本领域技术人员可容易看出其他优点和修改形式。此外,虽然已经结合内窥镜式切割和缝合器械描述了本文所公开的实施例,但可以想到与任何合适的医疗器械相关的其他实施例。尽管已经将本发明作为示例性设计进行了描述,但还可以在本公开的精神和范围内对本发明进行修改。因此本发明旨在涵盖采用本发明一般原理的任何变型型式、用途或适应型式。此外,本发明旨在涵盖本发明之外但在本发明所属领域的已知或惯有实践范围内的偏差型式。
除了上述之外,以上已经结合切割型外科器械对本发明的各种实施例进行了描述。然而应该指出的是,在其他实施例中,本文所公开的外科器械不必是切割型外科器械。例如,其可以为非切割型内窥镜式器械、抓紧器、缝合器、施夹器、进入装置、药物/基因治疗剂递送装置、利用超声波、射频、激光等的能量装置。虽然已经结合某些已公开的实施例在本文中描述了本发明,但可以对这些实施例进行多种修改和变化。例如,可以采用不同类型的端部执行器。另外,凡是公开了用于某些元件的材料的,均可使用其他材料。上述具体实施方式和下述权利要求旨在涵盖所有这样的修改和变化形式。
除以上所述,本文所公开的各种钉仓可为一次性的。在至少一个实施例中,消耗的钉仓或至少部分消耗的钉仓能够从手术缝合器中取出并用另一钉仓替换。在其他各种实施例中,钉仓不能够在外科器械的正常使用过程中移除和/或更换,但是在一些情况下,能够在重新调整手术缝合器(如下文详述)的同时和/或之后进行更换。在各种实施例中,钉仓可为一次性加载装置或端部执行器的一部分,该加载装置或端部执行器还可包括钉仓载体、砧座、切割构件和/或缝钉驱动器。在至少一个这样的实施例中,一次性加载装置或端部执行器的全部或至少一部分能够被可拆卸地连接至外科器械并可能够更换。
本文公开的装置能够被设计为在一次使用之后丢弃,或它们能够被设计为多次使用。然而在任一种情况下,该装置都可在至少使用一次后经过修理再使用。修理可包括拆卸装置、清洗或更换具体部件、以及后续重新组装步骤的任何组合。具体地讲,可拆卸该装置,并且可按照任何组合选择性地更换或拆下装置的任何数量的特定零件或部件。清洗和/或更换特定部件后,可在修理厂或在紧临外科手术前由手术小组人员将器械重新装配,以供后续使用。本领域技术人员将会知道,装置的修理可利用拆卸、清洁/更换、和再组装的多种技术。这些技术的使用以及所得的修复器械均在本发明的范围内。
优选的是,本文所述的发明将在外科手术之前进行处理。首先,获取新的或用过的器械,并根据需要进行清洗。然后可对器械进行消毒。在一种消毒技术中,将器械置于闭合并密封的容器中,诸如塑料或TYVEK口袋中。然后将容器和器械置于可穿透该容器的辐射场,例如γ辐射、X射线或高能电子。辐射将杀死器械上和容器中的细菌。然后可将消毒后的器械保存在消毒容器中。该密封容器将器械保持在无菌状态,直到在医疗设备中打开该容器。
以引用方式全文或部分地并入本文的任何专利公布、或其他公开材料仅在所并入的材料不与本发明所述的现有定义、陈述、或其他公开材料相冲突的程度上并入本文。同样地并且在必要的程度下,本文明确阐述的公开内容取代了以引用方式并入本文的任何冲突材料。

Claims (28)

1.一种外科手术缝合器,其包括:
轴;
第一磁性元件;
关节接头;
第二磁性元件;和
端部执行器,其中所述端部执行器通过所述关节接头可运动地连接到所述轴,所述端部执行器包括:
能够接纳钉仓的钉仓通道;和
可运动地连接到所述钉仓通道的砧座,其中所述第一磁性元件和所述第二磁性元件中的一者能够向所述第一磁性元件和所述第二磁性元件中的另一者施加磁力,并且其中所述磁力足以使所述端部执行器相对于所述轴进行关节运动。
2.根据权利要求1所述的外科手术缝合器,还包括致动器和电源,其中所述致动器能够致动以可操作地连接所述电源和所述第一磁性元件。
3.根据权利要求2所述的外科手术缝合器,其中所述第一磁性元件包括电磁体,所述电磁体能够被来自所述电源的电流通电。
4.根据权利要求3所述的外科手术缝合器,其中所述致动器能够转变供应到所述电磁体的电流的极性。
5.根据权利要求1所述的外科手术缝合器,其中所述第一磁性元件能够产生磁场。
6.根据权利要求5所述的外科手术缝合器,其中所述磁场足以锁定所述端部执行器相对于所述轴的位置。
7.根据权利要求1所述的外科手术缝合器,其中所述第二磁性元件包括永久磁体。
8.根据权利要求1所述的外科手术缝合器,其中所述第二磁性元件包括铁。
9.根据权利要求1所述的外科手术缝合器,其中所述关节接头包括第一接头构件和第二接头构件,其中所述第一磁性构件安装到所述第一接头构件,其中所述第二磁性构件安装到所述第二接头构件,并且其中所述第二接头构件能够相对于所述第一接头构件进行关节运动。
10.根据权利要求9所述的外科缝合器,其中所述第一接头构件能够相对于所述轴进行关节运动,并且其中所述端部执行器能够相对于所述第二接头构件进行关节运动。
11.根据权利要求9所述的外科缝合器,其中所述第一接头构件和所述第二接头构件中的一者包括球构件,其中所述第一接头构件和所述第二接头构件中的另一者包括承窝,并且其中所述球构件能够在所述承窝内运动,以允许所述第二接头构件相对于所述第一接头构件进行关节运动。
12.根据权利要求11所述的外科缝合器,其中所述球构件和所述承窝中的一者包括凸缘,其中所述球构件和所述承窝中的另一者包括凹槽,所述凹槽能够接纳所述凸缘,并且其中所述凸缘和所述凹槽能够限定平面,所述端部执行器能够在所述平面内相对于所述轴进行关节运动。
13.根据权利要求9所述的外科缝合器,还包括延伸穿过所述第一接头构件和所述第二接头构件的弹性杆,其中所述弹性杆能够将所述端部执行器偏置到未进行关节运动的位置。
14.根据权利要求13所述的外科缝合器,其中所述第一接头构件包括第一杆孔,所述第二接头构件包括第二杆孔,其中所述弹性杆可滑动地接纳在所述第一杆孔和所述第二杆孔内,其中所述弹性杆安装到所述端部执行器和所述轴中的一者,并且其中所述端部执行器和所述轴中的另一者包括端部杆孔,所述端部杆孔能够可滑动地接纳所述弹性杆的端部。
15.一种外科手术缝合器,其包括:
轴;
关节接头,所述关节接头包括:
第一接头构件,所述第一接头构件包括第一电磁体和第二电磁体;
第二接头构件,所述第二接头构件包括第一磁性元件和第二磁性元件,其中所述第二接头构件能够相对于所述第一接头构件进行关节运动;
端部执行器,其中所述端部执行器通过所述关节接头可运动地连接到所述轴,所述端部执行器包括:
能够接纳钉仓的钉仓通道;和
可运动地连接到所述钉仓通道的砧座,其中所述第一电磁体能够有选择地产生第一磁场,所述第一磁场能够使所述第一磁性元件相对于所述第一电磁体运动、并使所述端部执行器沿第一方向进行关节运动,并且其中所述第二电磁体能够有选择地产生第二磁场,所述第二磁场能够使所述第二磁性元件相对于所述第二电磁体运动、并使所述端部执行器沿第二方向进行关节运动。
16.根据权利要求15所述的外科手术缝合器,其中所述关节接头还包括关节运动轴线,其中所述第一电磁体定位在所述关节运动轴线的第一侧上,并且其中所述第二电磁体定位在所述关节运动轴线的大致相对侧上。
17.根据权利要求16所述的外科手术缝合器,其中所述第一磁性元件与所述第一电磁体沿第一轴线对齐,其中所述第二磁性元件与所述第二电磁体沿第二轴线对齐,其中所述第一轴线大致平行于所述关节运动轴线,并且其中所述第二轴线大致平行于所述关节运动轴线。
18.根据权利要求15所述的外科手术缝合器,其中所述第一接头构件还包括第三电磁体和第四电磁体,其中所述第二接头构件还包括第三磁性元件和第四磁性元件,其中所述第三电磁体能够有选择地产生第三磁场,所述第三磁场能够使所述第三磁性元件相对于所述第三电磁体运动、并使所述端部执行器沿第三方向进行关节运动,并且其中所述第四电磁体能够有选择地产生第四磁场,所述第四磁场能够使所述第四磁性元件相对于所述第四电磁体运动、并使所述端部执行器沿第四方向进行关节运动。
19.一种外科手术缝合器,其包括:
轴;
端部执行器,其中所述端部执行器可运动地连接到所述轴,所述端部执行器包括:
能够接纳钉仓的钉仓通道;和
可运动地连接到所述钉仓通道的砧座;
安装到所述轴的第一电磁体;
安装到所述轴的第二电磁体;
安装到所述端部执行器的多个磁性元件,其中所述第一电磁体能够产生第一磁场,以使所述磁性元件中的至少一个运动,并使所述端部执行器沿第一方向进行关节运动,并且其中所述第二电磁体能够产生第二磁场,以使所述磁性元件中的至少一个运动,并使所述端部执行器沿第二方向进行关节运动。
20.根据权利要求20所述的外科手术缝合器,其中所述多个磁性元件包括多个永久磁体,并且其中所述永久磁体在所述端部执行器上布置成弓形阵列。
21.根据权利要求21所述的外科手术缝合器,其中每个所述永久磁体包括正极和负极,并且其中所述永久磁体被布置成使得它们的正极和负极处于交替布置方式。
22.根据权利要求20所述的外科手术缝合器,还包括传感器,其中所述端部执行器还包括多个可检测的特征件,所述可检测的特征件能够被所述传感器检测到,并且其中所述可检测的特征件能够指示所述端部执行器相对于所述轴的位置。
23.根据权利要求22所述的外科手术缝合器,其中所述传感器可包括光电传感器,并且其中所述可检测的特征件可包括至少部分为环形的标记阵列。
24.一种外科手术缝合器,其包括:
轴,所述轴包括近侧磁性元件;
端部执行器,所述端部执行器可运动地连接到所述轴,所述端部执行器包括:
能够接纳钉仓的钉仓通道;
可运动地连接到所述钉仓通道的砧座;和
远侧磁性元件,以及
关节接头,所述关节接头包括至少一个定位在所述近侧磁性元件和所述远侧磁性元件中间的中间磁性元件,其中所述近侧磁性元件能够向所述中间磁性元件施加第一磁力,其中所述中间磁性元件能够向所述远侧磁性元件施加第二磁力,并且其中所述第一磁力和第二磁力足以使所述端部执行器相对于所述轴进行关节运动。
25.根据权利要求24所述的外科手术缝合器,其还包括致动器,其中所述致动器可操作地连接到电源,并且其中所述致动器能够有选择地向所述近侧磁性元件供应电流。
26.根据权利要求25所述的外科手术缝合器,其中向所述近侧磁性元件供应的所述电流足以锁定所述中间磁性元件相对于所述轴的位置。
27.根据权利要求25所述的外科手术缝合器,其中所述致动器能够有选择地转变供应到所述近侧磁性元件的电流的极性。
28.根据权利要求24所述的外科手术缝合器,还包括致动器,其中所述致动器的操作能够改变所述近侧磁性元件的极性。
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